Advertisement


Fabrice Andre, MD, PhD, on Breast Cancer: Interim Analysis From DESTINY-Breast07

2024 ASCO Annual Meeting

Advertisement

Fabrice Andre, MD, PhD, of Gustave Roussy and the Université Paris-Saclay, discusses a dose-expansion interim analysis of trastuzumab deruxtecan (T-DXd) monotherapy and T-DXd plus pertuzumab in patients with previously untreated HER2-positive metastatic breast cancer (Abstract 1009).



Transcript

Disclaimer: This video transcript has not been proofread or edited and may contain errors.
HER2 overexpression breast cancer represents around 20% of patients with metastatic breast cancer. The outcome in recent trials is around 50 to 60 months median overall survival with the first-line therapy being Taxane plus Trastuzumab plus Pertuzumab, and this combination provides around 18 months progression-free survival. In this context, there is a need to improve the outcome of these patients. Trastuzumab Deruxtecan is a new drug, it is an antibody-drug conjugate that targets HER2. This drug has shown efficacy in patients who present with HER2 overexpression metastatic breast cancer, previously treated with Taxane Pertuzumab Trastuzumab. In this context, the question is whether giving Trastuzumab Deruxtecan in the first-line setting could improve the outcome of patients. Before moving to the Phase IV / Phase III, it was necessary to run the Phase I / Phase II to explore the safety and preliminary signal of efficacy. In DESTINY-Breast07 Phase I / Phase II, 75 patients were included in the first-line setting to receive Trastuzumab Deruxtecan. 50 patients were included again in the first-line setting to receive Trastuzumab Deruxtecan plus Pertuzumab. What are the results? The response rate was 76% in patients who received Trastuzumab Deruxtecan single agent, and was 84% in the group of patients who received Trastuzumab Deruxtecan plus Pertuzumab. In terms of progression-free survival, it's too early to conclude. Nevertheless, more than 80% of the patients, whether they were treated with Trastuzumab Deruxtecan or T-DXd plus Pertuzumab, more than 80% of the patients had a progression-free survival more than 12 months. Meaning that the disease is controlled for the vast majority of patients for more than 12 months. Then in terms of subgroup, there was no difference of efficacy according to the expression of hormone receptor or whether the disease was recurrent after adjuvant therapy or de novo. In terms of safety, around 10% of patients presented with ILD, which is lung toxicity. Nevertheless, no toxic death was observed. One toxicity that was moderate, but that was increased with Pertuzumab, was diarrhea, but still the number and the percentage are very small. So what can we say about this study? It's a Phase I / Phase II study that tells us that in the first-line setting, T-DXd or T-DXd plus Pertuzumab, provides encouraging preliminary signal of efficacy, and that was the rationale to start a Phase III trial testing this new drug in the first-line setting as compared to the standard of care, and hopefully will improve the outcome of the patients.

Related Videos

Multiple Myeloma

Suzanne Trudel, MD, on Multiple Myeloma: Results From the DREAMM-8 Study of Treatments After Relapse

Suzanne Trudel, MD, of Canada’s Princess Margaret Cancer Centre, discusses phase III findings showing that, in patients with relapsed or refractory multiple myeloma who had one or more prior lines of treatment, belantamab mafodotin-blmf plus pomalidomide and dexamethasone improved progression-free survival and showed a favorable overall survival trend compared with pomalidomide plus bortezomib and dexamethasone.

Gynecologic Cancers

Mostafa Eyada, MD, on Oral Cyclophosphamide Plus Bevacizumab in Recurrent Ovarian Cancer

Mostafa Eyada, MD, of The University of Texas MD Anderson Cancer Center, discusses study results showing that bevacizumab in combination with oral cyclophosphamide had a response rate of 40% in patients with recurrent platinum-resistant high-grade ovarian cancer (Abstract 5517).

Lung Cancer

Narjust Florez, MD, and David R. Spigel, MD, on Limited-Stage Small Cell Lung Cancer: Results From the ADRIATIC Study

Narjust Florez, MD, of Dana-Farber Cancer Institute, and David R. Spigel, MD, of Sarah Cannon Research Institute, discuss phase III findings showing that durvalumab as consolidation treatment after concurrent platinum-based chemoradiotherapy improved survival outcomes compared with placebo in patients with limited-stage small cell lung cancer. According to Dr. Spigel, these data support durvalumab as a new standard of care in this population (Abstract LBA5).

Lymphoma

David J. Andorsky, MD, on DLBCL and FL: New Data on Use of Subcutaneous Epcoritamab

David J. Andorsky, MD, of the Sarah Cannon Research Institute and Rocky Mountain Cancer Centers, discusses EPCORE NHL-6, an ongoing study of patients with relapsed or refractory diffuse large B-cell lymphoma (DLBCL) and follicular lymphoma (FL). As outpatients, the study participants were given subcutaneous epcoritamab-bysp to see whether they could be safely monitored and cytokine-release syndrome appropriately managed in the outpatient setting (Abstract 7029).

Kidney Cancer

Toni K. Choueiri, MD, FASCO, on RCC: Biomarker Analysis From the CLEAR Trial

Toni K. Choueiri, MD, FASCO, of the Dana-Farber Cancer Institute, discusses phase III findings showing that, in patients with advanced renal cell carcinoma (RCC), the benefit of lenvatinib plus pembrolizumab vs sunitinib in overall response rate does not appear to be affected by such factors as geneexpression signatures for tumorinduced proliferation, PDL1 status, or the mutation status of RCC driver genes.

Advertisement

Advertisement




Advertisement