T-DXd: Breakthrough for Brain Metastases

In this clip from CHM Conversations, Dr. Jason Mouabbi and Dr. Paolo Tarantino dive into the pivotal DESTINY-Breast12 trial, which evaluated trastuzumab deruxtecan (T-DXd) in HER2-positive metastatic breast cancer patients with active brain metastases, a rare group to be included in studies.

They discuss how T-DXd PFS curves were almost identical between those with or without active brain metastases, as well as opine on what treatment sequence to integrate T-DXd regardless of the brain metastatic activity. They also comment that it should now be the clear second line, notwithstanding the relatively increased ILD risk in the active brain metastatic subgroup, as these patients were most likely more vulnerable from the start owing to ongoing steroids and ILD can be closely screened, and the rates were still in extreme minority when compared to the burden of the metastatic BC.