Reducing Recurrence in HER2-Positive Breast Cancer with Residual Disease

Clinical Takeaway

: In patients at high risk of recurrence, adjuvant T-DXd improved invasive disease–free survival over standard treatment with T-DM1.

Context

Patients with early-stage human epidermal growth factor receptor 2 (HER2)–positive breast cancer frequently receive neoadjuvant HER2-directed therapy. However, some will have residual invasive disease at surgery, putting them at increased risk of recurrence. The standard adjuvant therapy for patients with residual disease has been trastuzumab emtansine (T-DM1), but increasing data show greater efficacy with trastuzumab deruxtecan (T-DXd) than with T-DM1 in patients with metastatic disease. Could T-DXd also reduce recurrence risk over T-DM1 in those with early disease?

In the industry-funded, open-label DESTINY-Breast05 trial, over 1600 patients with early breast cancer who had residual invasive disease and high recurrence risk followi…

Reviewing Author

William J. Gradishar, M.D.

Disclosures

Consultant/Advisory BoardLilly; AstraZeneca; Gilead; Stemline; Genentech; Arvinas; Celcuity

Grant/Research SupportBreast Cancer Research Foundation

Editorial BoardsClinical Breast Cancer; Oncology; Annals of Surgery

Leadership Positions in Professional SocietiesNational Comprehensive Cancer Network (Chair, Breast Cancer Panel); American Board of Internal Medicine (Medical Oncology Board)