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Open Access 17-06-2024 | Trastuzumab Deruxtecan | Original Article

Trastuzumab deruxtecan versus treatment of physician’s choice in previously treated Asian patients with HER2-low unresectable/metastatic breast cancer: subgroup analysis of the DESTINY-Breast04 study

Authors: Toshinari Yamashita, Joo Hyuk Sohn, Eriko Tokunaga, Naoki Niikura, Yeon Hee Park, Keun Seok Lee, Yee Soo Chae, Binghe Xu, Xiaojia Wang, Seock-Ah Im, Wei Li, Yen-Shen Lu, Cecilia Orbegoso Aguilar, Soichiro Nishijima, Yuji Nishiyama, Masahiro Sugihara, Shanu Modi, Junji Tsurutani

Published in: Breast Cancer

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Abstract

Background

In the global phase 3 DESTINY-Breast04 study (NCT03734029), the anti-human epidermal growth factor 2 (HER2) antibody–drug conjugate trastuzumab deruxtecan (T-DXd) demonstrated a statistically significant improvement in progression-free survival (PFS) and overall survival (OS), with manageable safety compared with treatment of physician’s choice (TPC) in patients with HER2-low metastatic breast cancer (mBC) who had received 1–2 prior lines of chemotherapy.

Methods

This subgroup analysis examined the efficacy and safety of T-DXd versus TPC in 213 patients from Asian countries and regions who were enrolled in the DESTINY-Breast04 trial and randomized to T-DXd (n = 147) or TPC (n = 66).

Results

Median PFS with T-DXd and TPC was 10.9 and 5.3 months, respectively, in Asian patients with hormone receptor-positive mBC, and 10.9 and 4.6 months, respectively, in the overall Asian population. In both populations, median OS was not reached with T-DXd and was 19.9 months with TPC. The objective response rate was higher with T-DXd versus TPC in all Asian patients. Median treatment duration was 8.4 months with T-DXd and 3.5 months with TPC. The most common grade ≥ 3 drug-related treatment-emergent adverse events in Asian patients treated with T-DXd were neutropenia (16.3%), anemia (12.9%), and leukopenia (11.6%); the incidences of neutropenia and leukopenia were higher with TPC versus T-DXd. Adjudicated drug-related interstitial lung disease or pneumonitis with T-DXd was 14.3%; the majority of events were grade 1–2.

Conclusions

T-DXd demonstrated clinically meaningful survival benefits versus TPC in Asian HER2-low mBC patients, regardless of hormone receptor status, with no new safety signals.

Clinical trial registration number

ClinicalTrials.gov, NCT03734029.
Appendix
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Literature
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Metadata
Title
Trastuzumab deruxtecan versus treatment of physician’s choice in previously treated Asian patients with HER2-low unresectable/metastatic breast cancer: subgroup analysis of the DESTINY-Breast04 study
Authors
Toshinari Yamashita
Joo Hyuk Sohn
Eriko Tokunaga
Naoki Niikura
Yeon Hee Park
Keun Seok Lee
Yee Soo Chae
Binghe Xu
Xiaojia Wang
Seock-Ah Im
Wei Li
Yen-Shen Lu
Cecilia Orbegoso Aguilar
Soichiro Nishijima
Yuji Nishiyama
Masahiro Sugihara
Shanu Modi
Junji Tsurutani
Publication date
17-06-2024
Publisher
Springer Nature Singapore
Published in
Breast Cancer
Print ISSN: 1340-6868
Electronic ISSN: 1880-4233
DOI
https://doi.org/10.1007/s12282-024-01600-7

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