An international team of researchers has reported promising results from the DESTINY-Breast12 trial, indicating that trastuzumab deruxtecan significantly extends survival in patients with HER2-positive advanced breast cancer, particularly those with brain metastases. The study, published in Nature Medicine, offers new hope for patients with limited treatment options.
Brain metastases occur in approximately 50% of patients with advanced HER2-positive breast cancer, and effective treatments have been lacking due to the blood-brain barrier hindering drug penetration. Current therapies, such as surgery and radiotherapy, often provide limited survival benefits.
Targeted Therapy Shows Promise
Trastuzumab deruxtecan is an antibody-drug conjugate (ADC) designed to target HER2-positive cancer cells. The antibody component, trastuzumab, binds specifically to the HER2 protein, delivering the cytotoxic payload, deruxtecan, directly to the tumor. This targeted approach minimizes toxicity to healthy tissues.
Professor Nadia Harbeck, Director of the Breast Center at LMU University Hospital and co-lead investigator of the DESTINY-Breast12 study, emphasized the significance of the findings: "These findings offer hope to patients with brain metastases in particular."
DESTINY-Breast12 Trial Details
The DESTINY-Breast12 trial enrolled over 500 patients with and without brain metastases from 78 cancer centers across Western Europe, Japan, Australia, and the United States. The study evaluated the efficacy of trastuzumab deruxtecan in this patient population.
The results showed that patients treated with trastuzumab deruxtecan survived an average of over 17 months without any progression of the cancer. Furthermore, more than 60% of patients survived 12 months without further tumor growth. Notably, the researchers observed regression of brain metastases in over 70% of participants. 90% of all patients were alive one year after the start of treatment.
Implications for Clinical Practice
Trastuzumab deruxtecan is already approved for use in standard practice. Professor Harbeck attests that the ADC has "great potential for the treatment of breast cancer." The ADAPT HER2 IV trial is evaluating the use of trastuzumab deruxtecan in patients with early, non-metastasized HER2-positive breast cancer in Germany, administering the ADC four times before surgery to simplify and shorten therapy.
