T-DXd Successfully Controls Brain Metastases

According to the phase IIIb/IV DESTINYBreast-12 Trial, the results of which were presented at the ESMO Congress in Barcelona, Spain, and concurrently published, the Daiichi Sankyo/Astra Zeneca antibody–drug conjugate trastuzumab deruxtecan (Enhertu; T-DXd) demonstrated substantial and durable efficacy in patients with HER2-positive breast cancer—including those with brain metastases (Nat Med 2024 Sep 13 [Epub ahead of print]). Among the 263 patients in the trial with brain metastases, the 12-month progression-free survival (PFS) rate was 61.6% and the 12-month central nervous system PFS was 58.9%. Results were similar between patients with stable and active brain metastases—60.1% and 57.8% respectively. Researchers noted that T-DXd could spare patients with HER2-positive disease and brain metastases from radiotherapy, which carries a risk of significant toxicity.