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lung cancer

DESTINY-Lung02: T-DXd for HER2-Mutant Metastatic NSCLC

As reported in the Journal of Clinical Oncology by Goto et al, primary results of the phase II DESTINY-Lung02 trial have shown activity of fam-trastuzumab deruxtecan-nxki (T-DXd) in patients with HER2-mutant metastatic non–small cell lung cancer (NSCLC) previously treated with platinum-containing...

breast cancer

New Challenge in Triple-Negative Breast Cancer: Optimizing the Sequencing of Treatments

New approaches are offering hope for better outcomes in metastatic triple-negative breast cancer, according to Suchita Pakkala, MD, of Emory University’s Winship Cancer Institute, Atlanta. She shared her thoughts on using PARP inhibitors and antibody-drug conjugates at the 2023 Debates and...

Expert Point of View: Barbara Pistilli, MD

The invited discussant of the study by Bar et al, Barbara Pistilli, MD, Head of the Breast Cancer Unit at Gustave Roussy Cancer Center, Villejuif, France, noted that third-generation antibody-drug conjugates, such as fam-trastuzumab deruxtecan-nxki (T-DXd), are showing activity across a wide range ...

breast cancer

HER2-Low Status Is ‘Dynamic’ for Patients With Triple-Negative Breast Cancer

The probability of obtaining a HER2-low test result increases with the number of biopsies performed, according to a study of more than 500 biopsy samples in patients with triple-negative breast cancer. For patients originally labeled as having no HER2 expression (HER2 0), each successive biopsy...

breast cancer

ASCO-CAP Guideline Update Confirms Previous Recommendations for HER2 Testing in Breast Cancer

In partnership with the College of American Pathologists (CAP), ASCO has affirmed findings from its 2018 practice guideline on the use of HER2 testing in breast cancer. Notably, the ASCO/CAP expert panel found there is currently no justification for a new designation of HER2 test results for...

breast cancer
immunotherapy

Expert Point of View: Barbara Pistilli, MD

Barbara Pistilli, MD, Head of the Breast Cancer Unit in the Medical Oncology Department of Gustave Roussy Cancer Center, Villejuif, France, was invited to discuss the TROPiCS-02 updated analysis. She began by pointing out that the target landscape of antibody-drug conjugates is “expanding...

gastrointestinal cancer

Roundup of Abstracts on New Therapies for Gastrointestinal Cancers From ASCO 2023

The 2023 ASCO Annual Meeting featured thousands of abstracts. In addition to our in-depth coverage of pivotal research from the meeting, The ASCO Post highlights the following studies of novel therapies for gastrointestinal cancers. Addition of Anti-TIGIT Agent in Unresectable Liver Cancer In the...

Expert Point of View: Gustavo Werutsky, MD and Lisa A. Carey, MD, ScM, FASCO

Invited discussant Gustavo Werutsky, MD, emphasized that health-related quality of life was consistently maintained in all phase III trials with fam-trastuzumab deruxtecan-nxki (T-DXd) in the metastatic breast cancer setting. Dr. Werutsky also highlighted the need for real-world data to understand...

breast cancer
palliative care

Two Studies Highlight Benefits in Quality of Life and Symptom Management With Novel Treatments of Advanced Breast Cancer

Recent improvements in overall and progression-free survival for patients with HER2-positive and estrogen receptor–positive breast cancers have not come at the expense of quality of life or symptom management, according to a pair of studies presented at the European Society for Medical Oncology...

Expert Point of View: Kohei Shitara, MD and Bradley Alexander McGregor, MD

At the ASCO session on the phase II DESTINY-PanTumor02 trial on T-DXd, the invited discussant, Kohei Shitara, MD, commented: “As expected, this trial demonstrated a very impressive response rate and duration of response” and “showed T-DXd [fam-trastuzumab deruxtecan-nxki] to be a potential new...

solid tumors

DESTINY-PanTumor02: Is T-DXd Heading for Tumor-Agnostic Status?

Fam-trastuzumab deruxtecan-nxki (T-DXd) may prove to be beneficial in a variety of treatment-refractory solid tumors that express HER2, according to findings from the international phase II DESTINY-PanTumor02 trial presented at the 2023 ASCO Annual Meeting.1 For patients with the highest HER2...

gastroesophageal cancer
gastrointestinal cancer
immunotherapy

T-DXd in HER2-Positive Advanced Gastric or Gastroesophageal Junction Cancer: DESTINY-Gastric02

In the phase II DESTINY-Gastric02 trial reported in The Lancet Oncology, Eric Van Cutsem, MD, PhD, and colleagues found that fam-trastuzumab deruxtecan-nxki (T-DXd) was active in patients with HER2-positive advanced gastric or gastroesophageal junction cancer with disease progression on or after a...

solid tumors

Funda Meric-Bernstam, MD, on HER2-Expressing Solid Tumors: Efficacy and Safety of Trastuzumab Deruxtecan

Funda Meric-Bernstam, MD, of The University of Texas MD Anderson Cancer Center, discusses interim results from the DESTINY-PanTumor02 trial, the first tumor-agnostic global study of fam-trastuzumab deruxtecan-nxki (T-DXd) in a broad range of HER2-expressing solid tumors. This agent showed an...

solid tumors
immunotherapy

Study Finds T-DXd Effectively Treats HER2-Expressing Cancers, Regardless of Tumor Location

According to the findings of the international phase II DESTINY-PanTumor02 study presented by Funda Meric-Bernstam, MD, and colleagues at the 2023 ASCO Annual Meeting, fam-trastuzumab deruxtecan-nxki (T-DXd) is an effective treatment option for people with difficult-to-treat, HER2-expressing solid...

breast cancer

Trastuzumab Deruxtecan vs Physician’s Choice in HER2-Positive Metastatic Breast Cancer Previously Treated With Trastuzumab Emtansine

As reported in The Lancet by André et al, the phase III DESTINY-Breast02 trial has shown improved progression-free survival with fam-trastuzumab deruxtecan-nxki vs physician’s choice of treatment in patients with HER2-positive metastatic breast cancer who had received prior ado-trastuzumab...

gynecologic cancers
immunotherapy

T-DXd in HER2-Expressing Advanced or Recurrent Uterine Carcinosarcoma

In a Japanese phase II trial (STATICE) reported in the Journal of Clinical Oncology, Nishikawa et al found that fam-trastuzumab deruxtecan-nxki (T-DXd) showed activity in patients with HER2-expressing advanced or recurrent uterine carcinosarcoma. Study Details In the multicenter trial, 32 evaluable ...

breast cancer
immunotherapy

ASCO Updates Guideline on Sacituzumab Govitecan-hziy in Hormone Receptor–Positive, HER2-Negative Metastatic Breast Cancer

ASCO has released a rapid recommendation update to the guideline on chemotherapy and targeted therapy for endocrine-pretreated or hormone receptor–negative metastatic breast cancer, addressing the use of sacituzumab govitecan-hziy in patients with endocrine-resistant, hormone receptor–positive,...

breast cancer
immunotherapy

DESTINY-Breast03: T-DXd Improves Overall Survival vs T-DM1 in Previously Treated HER2-Positive Metastatic Breast Cancer

As reported in The Lancet by Sara A. Hurvitz, MD, of the David Geffen School of Medicine, University of California, Los Angeles, Jonsson Comprehensive Cancer Center, and colleagues, updated results of the phase III DESTINY-Breast03 trial showed significantly improved overall survival with...

breast cancer

‘Best of SABCS’: Top 7 Picks From the 2022 Meeting by Jame Abraham, MD, FACP

Among the high-quality abstract presentations at the San Antonio Breast Cancer Symposium (SABCS), a few always stand out as particularly meritorious. Each year, The ASCOPost asks our Associate Editor, breast cancer specialist Jame Abraham, MD, FACP, to give us his picks. Dr. Abraham is Chairman of ...

lung cancer

ASCO Updates ‘Living’ Guidelines on Stage IV NSCLC Based on DESTINY-Lung01, CodeBreaK100, Other Trials

ASCO has updated its living guidelines for therapy for stage IV non–small cell lung cancer (NSCLC) with and without driver alterations based on newly available evidence in the field.1,2 “Living guidelines are becoming more important as the field of oncology expands and developments occur more...

Expert Point of View: Maryam B. Lustberg, MD, MPH

Maryam B. Lustberg, MD, MPH, Chief of Breast Medical Oncology at Yale Cancer Center, New Haven, shared her thoughts on TROPiCS-02 with The ASCO Post. “The progression-free survival and overall survival results of the phase III TROPiCS-02 trial position sacituzumab govitecan-hziy as an important...

breast cancer

Challenges of Accurately Identifying HER2-Low Breast Cancers

The newly identified category of “HER2-low” breast cancer has raised many new issues in this malignancy now that the DESTINY Breast-041 trial determined that fam-trastuzumab deruxtecan-nxki (T-DXd) may effectively treat this tumor. Among the issues are challenges in accurately identifying just...

breast cancer

Updated Results of DESTINY-Breast03: T-DXd vs T-DM1 for Previously Treated Patients With HER2-Positive Metastatic Breast Cancer

As reported in The Lancet by Sara A. Hurvitz, MD, and colleagues, updated results of the phase III DESTINY-Breast03 trial showed significantly improved overall survival with fam-trastuzumab deruxtecan-nxki (T-DXd) vs ado-trastuzumab emtansine (T-DM1) in patients with HER2-positive unresectable or...

Expert Point of View: Jason Aboudi Mouabbi, MD

“These results [from the TRIO-US B-12 TALENT trial] are exciting and impressive in HER2-low, hormone receptor–positive patients. The authors were testing the waters and got a positive signal,” said Jason Aboudi Mouabbi, MD, a medical oncologist at MD Anderson Cancer Center, Houston. “The beauty of ...

breast cancer

Neoadjuvant T-DXd Demonstrates Activity in Phase II Study of Patients With HER2-Low Breast Cancer

A pilot study provides a signal that the novel HER2 antibody-drug conjugate fam-trastuzumab deruxtecan-nxki (T-DXd), is active in the neoadjuvant setting in patients with HER2-low breast cancer. Overall response rates were 75% with T-DXd alone and 63% when T-DXd was combined with endocrine therapy...

breast cancer
immunotherapy

Expert Point of View: Neelima Vidula, MD

Commenting on the DESTINY-Breast03 presentation at the 2022 San Antonio Breast Cancer Symposium, Neelima Vidula, MD, a medical oncologist at Mass General Cancer Center, said: “The results highlight the important survival differences of T-DXd [fam-trastuzumab deruxtecan-nxki] compared to T-DM1...

breast cancer
immunotherapy

T-DXd Confirmed as Preferred Second-Line Therapy for Metastatic HER2-Positive Breast Cancer

The antibody-drug conjugate fam-trastuzumab deruxtecan-nxki (T-DXd) proved to be superior to the antibody-drug conjugate ado-trastuzumab emtansine (T-DM1), significantly improving progression-free survival and overall survival, in women with unresectable or metastatic HER2-positive breast cancer as ...

breast cancer
immunotherapy

Sara A. Hurvitz, MD: New Findings on Neoadjuvant Trastuzumab Deruxtecan and Anastrozole in Early-Stage Breast Cancer

Sara A. Hurvitz, MD, of the University of California, Los Angeles, Jonsson Comprehensive Cancer Center, discusses phase II results from the TRIO-US B-12 TALENT study, which showed that patients with localized, hormone receptor–positive, HER2-low breast cancer who are treated with fam-trastuzumab...

breast cancer
immunotherapy

Sara A. Hurvitz, MD, on Updated Survival Results on T-DXd vs T-DM1 in Metastatic Breast Cancer

Sara A. Hurvitz, MD, of the University of California, Los Angeles, Jonsson Comprehensive Cancer Center, discusses phase III findings from the DESTINY-Breast03 study, which showed that second-line treatment with fam-trastuzumab deruxtecan-nxki (T-DXd) led to longer overall survival compared with...

Expert Point of View: Véronique Diéras, MD

The invited discussant of the phase I/II study of patritumab deruxtecan (HER3-DXd) was Véronique Diéras, MD, of the Eugène Marquis Centre, Rennes, France. She commented that HER3-DXd showed promising activity across breast cancer subtypes with heavily pretreated metastatic breast cancer. She...

breast cancer

Study Finds Patritumab Deruxtecan Active in HER3-Expressing Metastatic Breast Cancer

The HER3-directed antibody-drug conjugate patritumab deruxtecan (HER3-DXd) showed activity in patients with heavily pretreated HER3-expressing metastatic breast cancer in a phase I/II study. Ian E. Krop, MD, PhD, Associate Director, Yale Cancer Center, New Haven, Connecticut, presented these...

breast cancer
immunotherapy

T-DXd Yields Superior Outcomes Over Chemotherapy-Based Regimens in Patients Previously Treated With T-DM1: DESTINY-Breast02

Compared with capecitabine-based regimens, fam-trastuzumab deruxtecan-nxki (T-DXd) led to higher response rates and longer survival in the third-line setting for patients with HER2-positive metastatic breast cancer previously treated with ado-trastuzumab emtansine (T-DM1), according to results from ...

T-DXd Yields Longer Overall Survival than T-DM1 as Second-Line Treatment in Patients With HER2-Positive Metastatic Breast Cancer: DESTINY-Breast03

Second-line treatment with fam-trastuzumab deruxtecan-nxki (T-DXd) led to significantly longer overall survival compared with ado-trastuzumab emtansine (T-DM1) in patients with HER2-positive metastatic breast cancer, according to updated results from the DESTINY-Breast03 phase III clinical trial...

breast cancer
immunotherapy

Neoadjuvant T-DXd Shows Clinical Activity in Patients With HER2-Low Breast Cancer

Patients with localized, hormone receptor (HR)-positive, HER2-low breast cancer treated with fam-trastuzumab deruxtecan-nxki (T-DXd) in the neoadjuvant setting had an overall response rate of 75% without combining the agent with anastrozole and 63% in combination with anastrozole, according to...

gastroesophageal cancer
gastrointestinal cancer
immunotherapy

T-DXd in Pretreated Patients With HER2-Low Advanced Gastric or Gastroesophageal Junction Adenocarcinoma

As reported in the Journal of Clinical Oncology by Yamaguchi et al, an exploratory cohort analysis in a Japanese/South Korean phase II trial (DESTINY-Gastric01) indicated that fam-trastuzumab deruxtecan-nxki (TDX-d) showed activity in previously treated—but anti-HER2 treatment–naive—patients with...

breast cancer

Trastuzumab Deruxtecan for Advanced HER2-Low Breast Cancer

On August 5, 2022, fam-trastuzumab deruxte-can-nxki was approved for patients with unresectable or metastatic HER2-low (immunohistochemistry [IHC] 1+ or IHC 2+/in situ hybridization–negative) breast cancer who have received prior chemotherapy in the metastatic setting or developed disease...

breast cancer
immunotherapy

Expert Point of View: Shom Goel, MBBS, PhD

The invited discussant of the post hoc analysis of TROPiCS-02 was Shom Goel, MBBS, PhD, Laboratory Group Leader at the University of Melbourne and a consultant oncologist at the Peter MacCallum Cancer Centre in Australia. Dr. Goel noted there remains much to learn about the HER2-low subset of...

breast cancer
immunotherapy

TROPiCS-02: Efficacy of Sacituzumab Govitecan Within HER2-Negative Subsets of Breast Cancer

In a post hoc analysis of the phase III TROPiCS-02 trial, sacituzumab govite­can-hziy improved efficacy outcomes in HER2-negative immunohistochemistry (IHC) subgroups.1 Results were consistent with those of the intent-to-treat population of hormone receptor–positive/HER2-negative advanced breast...

issues in oncology

How to Advance Antiracist Approaches to Patient Engagement in AYA Oncology and Research

Among the topics discussed at the 4th Global Adolescent and Young Adult Cancer Congress held online in December 2021 was the urgent need for clinicians, researchers, and advocates in adolescent and young adult (AYA) oncology to join forces to eradicate racist approaches to patient engagement in...

breast cancer
immunotherapy

Expert Point of View: Debu Tripathy, MD

Debu Tripathy, MD, Professor and Chair of Breast Medical Oncology at The University of Texas MD Anderson Cancer Center, Houston, shared his thoughts on TROPiCS-02 with The ASCO Post. He said the study is important because it addresses the needs of “a population with limited options, whose...

breast cancer

Breast Cancer 2021–2022 Almanac

The past year has seen an unprecedented number of practice-changing advances across all three major breast cancer subtypes. For patients with early-stage triple-negative breast cancer, neoadjuvant chemotherapy plus pembrolizumab firmly entered the standard of care based on improvements in...

breast cancer
immunotherapy

T-DXd Improves Progression-Free Survival vs T-DM1 in Metastatic HER2-Positive Breast Cancer

As reported in The New England Journal of Medicine by Javier Cortés, MD, PhD, of the International Breast Cancer Center, Barcelona, and colleagues, the phase III DESTINY-Breast03 trial has shown significantly prolonged progression-free survival with fam-trastuzumab deruxtecan-nxki (T-DXd) vs...

Expert Point of View: Mafalda Oliveira, MD, PhD

The invited discussant of the TUXEDO-1 trial1 was Mafalda Oliveira, MD, PhD, of Vall d’Hebron University Hospital and Vall d’Hebron Institute of Oncology, Barcelona. Dr. Oliveira noted that 40% of the 15 patients in TUXEDO-1 had symptomatic disease, and 60% had central nervous system metastases...

breast cancer
immunotherapy

T-DXd Shows Efficacy Against Active Brain Metastases in HER2-Positive Breast Cancer

In the single-center phase II TUXEDO-1 trial of patients with advanced HER2-positive breast cancer, fam-trastuzumab-deruxtecan-nxki (T-DXd) showed efficacy in patients with active brain metastases, yielding intracranial responses in 73.3% of the population and a median progression-free survival of...

breast cancer
immunotherapy

Expert Point of View: Patricia LoRusso, DO, PhD

Invited discussant Patricia LoRusso, DO, PhD, of Yale School of Medicine, said to the assembled audience at the 2022 ASCO Annual Meeting: “I see you are as excited about these data as I am,” after the applause ended following Dr. Modi’s presentation. “I want to thank our colleagues for helping to...

breast cancer
immunotherapy

DESTINY-Breast04 Trial: T-DXd Significantly Improves Survival in Patients With HER2-Low Metastatic Breast Cancer

The antibody-drug conjugate fam-trastuzumab deruxtecan-nxki (T-DXd) doubled progression-free survival compared with chemotherapy alone in patients with “HER2-low” metastatic breast cancer—ie, patients with low levels of HER2 expression. The agent also extended overall survival for patients with low ...

Expert Point of View: Mafalda Oliveira, MD, PhD

The invited discussant of the BEGONIA trial,1 Mafalda Oliveira, MD, PhD, of Vall d’Hebron University Hospital and Vall d’Hebron Institute of Oncology, Barcelona, called the activity of the combination of durvalumab and datopotamab deruxtecan (Dato-DXd) “notable,” with a 74% response rate overall,...

breast cancer
immunotherapy

BEGONIA Trial Reports Activity With Datopotamab Deruxtecan Plus Durvalumab in Triple-Negative Breast Cancer

Preliminary results of the basket BEGONIA trial showed that the antibody-drug conjugate datopotamab deruxtecan (Dato-DXd), paired with the immune checkpoint inhibitor durvalumab, has strong activity in advanced or metastatic triple-negative breast cancer among patients not biomarker-selected for...

Recent FDA Approvals in Breast Cancer

In the past year, the U.S. Food and Drug Administration (FDA) approved four treatment options for patients with breast cancer, which are summarized herein. T-DXd for HER2-Low Breast Cancer On August 5, 2022, the FDA approved fam-trastuzumab deruxtecan-nxki (Enhertu; T-DXd) for adult patients with...

issues in oncology
breast cancer

ASCO Treatment Guidelines for HER2-Negative Metastatic Breast Cancer Updated to Reflect New Trastuzumab Deruxtecan Data

Just 1 month after the DESTINY-Breast04 data were presented at the 2022 ASCO Annual Meeting Plenary Session,1 an ASCO expert panel released updated guidance that endorses the adoption of the antibody-drug conjugate fam-trastuzumab deruxtecan-nxki (T-DXd) into clinical practice for patients with...

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