Trastuzumab deruxtecan in HER2-positive metastatic breast cancer and beyond
Jose Perez1,2, Laia Garrigós1, Maria Gion3,4
1International Breast Cancer Center, Quiron Group, Barcelona, Spain.
Introduction:
Despite the substantial improvements made in human epidermal growth factor receptor 2 (HER2)-targeted therapies since the approval of trastuzumab more than 20 years ago, there is still considerable unmet need in patients with HER2-expressing breast cancer (BC) and other solid tumors. Trastuzumab deruxtecan (T-DXd) is a newer antibody-drug conjugate approved for the treatment of metastatic breast cancer (BC) and gastric cancer (GC) and is under active investigation in other solid tumors, including non-small cell lung cancer, colorectal cancer, and HER2-low tumors.
Areas Covered:
The current treatment and investigational landscape of HER2-positive and HER2-low metastatic BC (mBC) and the preclinical and clinical trials investigating T-DXd. To identify relevant literature, a search was performed on English-language publications and congress abstracts.
Expert Opinion:
T-DXd is likely to become the standard of care for second-line treatment of HER2-positive mBC, and it may play a role in the treatment of hormone receptor-positive and triple-negative mBC with HER2-low expression. Because it was recently approved in the United States and Japan to treat HER2-positive metastatic GC, it holds promise for the treatment of other HER2-positive solid tumors, including colorectal cancer, non-small cell lung cancer, and HER2-low BC.
Insights
Trastuzumab deruxtecan (T-DXd) shows promise for HER2-positive and HER2-low breast cancer and gastric cancer. This antibody-drug conjugate may become a standard treatment for various HER2-expressing solid tumors.
Area of Science:
- Oncology
- Pharmacology
Background:
- Despite advancements in HER2-targeted therapies for breast cancer (BC) and other solid tumors, significant unmet needs persist.
- Trastuzumab deruxtecan (T-DXd) is an antibody-drug conjugate offering new therapeutic avenues.
Purpose of the Study:
- To review the current treatment landscape for HER2-positive and HER2-low metastatic breast cancer (mBC).
- To explore the investigational role of T-DXd in various solid tumors, including gastric cancer (GC).
Main Methods:
- Literature search of English-language publications and congress abstracts.
- Analysis of preclinical and clinical trial data for T-DXd.
Main Results:
- T-DXd is a potential standard of care for second-line HER2-positive mBC treatment.
- T-DXd shows promise in HER2-low hormone receptor-positive and triple-negative mBC.
- Recent approvals in the US and Japan for HER2-positive metastatic GC indicate broader potential.
Conclusions:
- T-DXd is expected to be a key treatment for HER2-positive mBC and metastatic GC.
- Further investigation is warranted for T-DXd in other HER2-expressing solid tumors like colorectal cancer and non-small cell lung cancer.
- T-DXd holds significant promise for patients with HER2-low breast cancer.
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