DESTINY-Breast11 in HER2-Positive Early Breast Cancer

Dr. Ruta Rao reviews the design and key findings of DESTINY-Breast11 in patients with high-risk HER2-positive early breast cancer receiving neoadjuvant therapy. She describes the study population, which included patients with clinical T3 or higher disease, node-positive disease from N1 to N3 regardless of tumor size, or inflammatory breast cancer. The discussion focuses on the randomized treatment strategies, including four cycles of T-DXd followed by four cycles of THP compared with dose-dense AC followed by THP, as well as the T-DXd monotherapy arm. Dr. Rao and Dr. Jason Mouabbi highlight the notable pathologic complete response rates observed with the T-DXd followed by THP approach, including particularly high responses among patients with hormone receptor-negative disease. They discuss the potential significance of these findings in the neoadjuvant management of high-risk HER2-positive early breast cancer and note that approximately two-thirds of patients receiving the T-DXd followed by THP regimen achieved a pathologic complete response after eight cycles of therapy.