Dr. George on the Background of the DESTINY-Breast04 Trial in HER2-Low Breast Cancer

Mridula George, MD, medical oncologist, Stacy Goldstein Breast Cancer Center, Rutgers Cancer Institute of New Jersey, assistant professor of medicine, Rutgers Robert Wood Johnson Medical School, discusses the background of the phase 3 DESTINY-Breast04 trial (NCT03734029) in breast cancer.

DESTINY-Breast04 evaluated fam-trastuzumab deruxtecan-nxki (Enhertu) vs physician’s choice of chemotherapy in patients with HER2-low, hormone receptor (HR)–positive metastatic breast cancer. Updated data from the trial were presented at the 2022 ASCO Annual meeting.

Data from prior studies showed that trastuzumab deruxtecan elicited impressive response rates in heavily pretreated patients with HER2-low tumors, leading to further investigation of the antibody-drug conjugate in DESTINY-Breast04, George emphasizes.

The randomized, open-label, global trial enrolled about 500 patients, who were randomized 2:1 to receive trastuzumab deruxtecan or chemotherapy, George adds. Patients with HR-positive breast cancer should have progressed on prior hormonal therapy and between 1 or 2 lines of prior chemotherapy in the metastatic setting, George explains.

Patients with HR-negative, HER2-low breast cancer needed to progress on 1 or 2 prior lines of chemotherapy, George says. Notably, patients with interstitial lung disease or active brain metastases were excluded from the trial, George concludes.