HER2+ ADVANCED BREAST CANCER: NEW DATA, NEW OPPORTUNITIES (ABC 2023)
Without any doubt, the best data come from trastuzumab deruxtecan (TDXd), a third-generation antibody-drug conjugate that had shown in 2021 an impressive improvement in progression-free survival (PFS) compared with TDM1...However, because these studies were not randomized, whether TDXd is a better option compared to tucatinib-based treatment in this setting remains a matter of debate...In the PHOEBE study, pyrotinib and capecitabine were compared with the combination of lapatinib and capecitabine...In addition, the Phila study showed an impressive improvement in PFS when pyrotinib was added to the docetaxel and trastuzumab combination, compared with placebo, trastuzumab and docetaxel. However, since the control arm did not include pertuzumab, this strategy is unlikely to change the standard of care in many countries...However, based on the latest results achieved by TDXd in patients with these cancers, HER2-low expressing tumours have become a new standard terminology. TDXd has shown to improve PFS and OS in patients with HER2-low mBC in the second/ third line treatment compared to the best chemotherapeutic agents (DB04 trial).