Dr. Krill-Jackson on the Potential Utility of Trastuzumab Deruxtecan in Metastatic Breast Cancer

Elisa Krill-Jackson, MD, associate director of community outreach for women's health, Sylvester Comprehensive Cancer Center, University of Miami Health System, discusses the potential utility of fam-trastuzumab deruxtecan-nxki (Enhertu) in metastatic breast cancer.

In December 2019, trastuzumab deruxtecan was granted accelerated approval by the FDA for the treatment of patients with unresectable or metastatic HER2-positive breast cancer who have received ≥2 prior anti­—HER2-based regimens in the metastatic setting. The designation was based on data from the phase II DESTINY-Breast01 trial which showed an overall response rate of 60.3% with the agent.

Data from initial studies with trastuzumab deruxtecan compare favorably to data with ado-trastuzumab emtansine (T-DM1; Kadcyla), says Krill-Jackson. As such, trastuzumab deruxtecan may have a role in the treatment of patients with low HER2 expression.

Findings from the DESTINY-Breast01 study showed that 13.6% of the 184 patients treated with trastuzumab deruxtecan developed treatment-related interstitial lung disease (ILD). Reducing the toxicity of the drug with better management strategies could lead to increased efficacy in earlier lines of treatment, including the adjuvant setting, explains Krill-Jackson.

Currently, the agent is being investigated in patients with HER2 1+ or 2+ disease, concludes Krill-Jackson.