Sufferers receiving Enhertu (fam-trastuzumab deruxtecan-nxki) for HER2-positive metastatic breast most cancers confirmed “outstanding” outcomes, though it might have completely different unintended effects than normal of care remedies, Dr. Nancy Lin defined to CURE® on the 2024 ESMO Congress.
Lin is a medical oncologist and scientific investigator within the Breast Oncology Heart on the Dana-Farber Most cancers Institute and Harvard Medical College, each in Boston.
LEARN MORE: Enhertu Demonstrates General, Intracranial Exercise in HER2-Constructive Breast Most cancers
Lin sat down with CURE® on the 2024 ESMO Congress to debate how Enhertu compares with normal of take care of sufferers with HER2-positive metastatic breast most cancers and the way Enhertu could also be tailor-made for sufferers’ particular wants and traits.
Transcript:
[Enhertu] confirmed actually excessive ranges of intracranial efficacy. I believe that what was very notable was that in sufferers with beforehand untreated mind metastases, the response price was 82% which I believe is actually outstanding. The median [progression-free survival (PFS; time patients live without disease worsening)] within the mind [metastases] cohort was over 17 months, once more, outstanding. And the 12-month general survival was over 90%.
There are clearly variations within the security profile between [Enhertu] and the routine that we frequently consider once we take into consideration treating sufferers with HER2-positive mind [metastases], and that’s the routine of [Tukysa] (tucatinib), [Xeloda] (capecitabine) and Herceptin (trastuzumab). That routine additionally produces CNS responses, [which] was about 50% in that examine, the median PFS there was simply over seven months. However there are variations within the security profile as effectively. So for [Enhertu], there’s extra nausea and vomiting, which could be very effectively managed with applicable antiemetic regimens. However there’s additionally the chance of [interstitial lung disease] that must be watched for very rigorously. With the [Herceptin, Tukysa and Xeloda] routine, we see extra diarrhea and hand-foot signs, primarily associated to the [Xeloda].
So I believe that what we’re seeing right here is that we’re seeing a number of energetic choices for sufferers, each with and with out mind metastases. And the fact is that the majority sufferers is not going to be cured with a number of of those regimens, and they’re going to truly undergo sequential regimens. It is actually extra a matter of sequence than a matter of both or, in my view, however the facet impact profiles are completely different.
Once we counsel sufferers about what decisions they may need to take into account. We’ll be eager about efficacy finish factors [end goals]. We’re additionally going to be eager about toxicity finish factors. And so for sufferers who do not need to lose their hair, maybe [Tukysa, Xeloda and Herceptin] could be a preferable preliminary choice. For sufferers who do not need to take care of the issues of oral therapies that they should maintain observe of at residence and like to return in as soon as each three weeks for an IV remedy, the [Enhertu] could also be preferable and for sufferers who’ve, for instance, co-existing liver metastases, the place we have seen that [Enhertu] has superior exercise to the earlier second-line normal of Kadcyla (ado-trastuzumab emtansine), I believe many sufferers in that scenario would possibly elect [Enhertu].
This transcript has been edited for readability and conciseness.
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