Is T-DXd + Pertuzumab the New FirstLine Standard? – Drs. Neil Iyengar, Komal Jhaveri, & Igor Makhlin

For more than a decade, CLEOPATRA defined first-line therapy in HER2-positive metastatic breast cancer.

Now, DESTINY-Breast09 is forcing a fundamental rethink.

In this in-depth roundtable, Drs. Neil Iyengar, Komal Jhaveri, and Igor Makhlin examine:

• The legacy — and limitations — of CLEOPATRA
• DESTINY-Breast09’s unprecedented ~40-month PFS
• When T-DXd + pertuzumab should move to the frontline
• Patient selection, toxicity management, and ILD vigilance
• Sequencing strategies after frontline ADCs
• How maintenance paradigms may evolve

A must-watch discussion on efficacy vs durability, escalation vs personalization, and what “best therapy first” truly means in 2025.