Dr. Mark Pegram and Dr. Neil Iyengar – T-DXd’s Rise in HER2+ & HER2-Low Breast Cancer

Direct from ESMO 2025 in Berlin, Dr. Mark Pegram and Dr. Neil Iyengar unpack what many are calling a new standard in HER2-directed therapy.

From DESTINY-Breast 11’s practice-changing neoadjuvant results to DESTINY-Breast 05 in the adjuvant setting — and now DESTINY-Breast 09 rewriting the metastatic playbook — the data are clear: trastuzumab deruxtecan (T-DXd) is transforming treatment across disease stages.

The discussion moves beyond HER2 + disease into HER2-low and ultra-low, touching on how new definitions, ADC sequencing, and precision testing could expand eligibility to the majority of breast cancers.