Trastuzumab deruxtecan for the late lines of treatment for HER2-low metastatic breast cancer: a clinical case
https://doi.org/10.17650/1994-4098-2024-20-4-95-100
Abstract
The new generation conjugate trastuzumab deruxtecan (Т-DXd) is indicated for the treatment of adult patients with unresectable or metastatic HER2-positive breast cancer (BC) who have previously received a drug regimen containing anti-HER2 targeted agents, as well as for the treatment of adult patients with unresectable or metastatic HER2-weakly positive breast cancer (1+ or 2+ by immunohistochemistry/negative by in situ hybridization) who have received prior systemic therapy for metastatic disease or who have relapsed during or within 6 months of completion of adjuvant chemotherapy. Given the positive data on the use of Т-DXd in different populations of patients with metastatic BC, it is advisable to collect data from real-world clinical practice to expand treatment options.
A 67-year-old female patient received Т-DXd as a sixth-line therapy for recurrent HER2-low metastatic BC, with a 20 % reduction in the size of the liver metastasis and no progression during therapy. The data of the clinical case were collected as part of a study of Т-DXd monotherapy in patients with metastatic BC who had previously received at least 2 lines of systemic therapy, in the real-life practice of the Clinical Oncological Dispensary No. 1 of Krasnodar.
The presented clinical case is consistent with the data of the clinical study DESTINY-Breast04 and shows the potential for using Т-DXd in real-life clinical practice in patients with metastatic HER2-weakly positive BC in late lines.
About the Authors
R. A. Murashko
Clinical Oncological Dispensary No. 1, Ministry of Health of the Krasnodar Territory
Russian Federation
Russian Federation
146 Dimitrova St., Krasnodar 350040, Russia
S. V. Sharov
Clinical Oncological Dispensary No. 1, Ministry of Health of the Krasnodar Territory
Russian Federation
Russian Federation
Sergey Viktorovich Sharov
146 Dimitrova St., Krasnodar 350040, Russia
E. P. Chashnikova
Russian Federation
individual entrepreneur
References
1. General characteristics of the medicinal product Enhertu (lyophilisate for the preparation of concentrate for the preparation of solution for infusions, 100 mg) dated 29 October 2024. Registration certificate LP-N(001242)-(RG-RU) dated 21 September 2022 (reissued 12 October 2023). Available at: https://astrazeneca.ru/api/media/Enhertu_OKhLP.pdf. (In Russ.).
2. Artamonova E.V., Lubennikova E.V. Choice of therapy for HER2-positive metastatic breast cancer in real clinical practice: analysis of physician preferences in Russian Federation. Diagnostika i onkoterapiya = Diagnostics and Oncotherapy 2024;(27):60–6. (In Russ.). DOI: 10.33667/2078-5631-2024-27-60-66
3. Cortés J., Kim S., Chung W. et al. Trastuzumab deruxtecan versus trastuzumab emtansine for breast cancer. N Engl J Med 2022;386(12):1143–54. DOI: 10.1056/NEJMoa2115022
4. Daiichi Sankyo, Inc. DS-8201a versus T-DM1 for human epidermal growth factor receptor 2 (HER2)-positive, unresectable and/or metastatic breast cancer previously treated with trastuzumab and taxane [DESTINY-Breast03]. Available at: https://www.clinicaltrials.gov/ct2/show/NCT03529110.
5. Hurvitz S.A., Kim S.B., Chung W.P. et al. Trastuzumab deruxtecan (T-DXd) versus trastuzumab emtansine (T-DM1) in patients with HER2+ metastatic breast cancer: subgroup analyses from the randomized phase 3 study DESTINY-Breast03. San Antonio Breast Cancer Symposium (SABCS) 2021 Annual Meeting, 7–10 December 2021.
6. Kolyadina I.V. Trastuzumab deruxtecan in the treatment of patients with advanced breast cancer with HER2-low expression: Recent studies review. Opukholi zhenskoy reproduktivnoy sistemy = Tumors of Female Reproductive System 2023;19(3):63–76. (In Russ.). DOI: 10.17650/1994-4098-2023-19-3-63-76
7. Apanasevich V.I., Artamonova E.V., Ashrafyan L.A. et al. Clinical recommendations of the Russian Society of Oncology and Mammology “Gold standard for prevention, diagnosis, treatment and rehabilitation of patients with breast cancer”. Russian Society of Oncomammologists, 2024. 297 p. Available at: https://docs.google.com/document/d/14XU19rSHmmg0v8aL9msY9B1uoscVK7WS/edit?tab=t.0#heading=h.gjdgxs. (In Russ.).
8. Tyulyandin S.A., Artamonova E.V., Zhigulev A.N. et al. Breast cancer. RUSSCO practical recommendations, part 1.2. Zlokachestvennye opukholi = Malignant Neoplasms 2024;14(3s2):32–81. (In Russ.).
9. Avxentyev N.A., Makarova Yu.V., Makarov A.S. Modeling the impact of using trastuzumab deruxtecan in patients with breast cancer on reducing cancer mortality in Russia. Opukholi zhenskoy reproduktivnoy sistemy = Tumors of Female Reproductive System 2024;20(2):55–65. (In Russ.).
10. Modi S., Jacot W., Yamashita T. et al. Trastuzumab deruxtecan in previously treated HER2-low advanced breast cancer. N Engl J Med 2022;387(1):9–20. DOI: 10.1056/NEJMoa2203690
11. Modi S., Jacot W., Yamashita T. et al. Trastuzumab deruxtecan (T-DXd) vs treatment of physician’s choice in patients with HER2-low unresectable and/or metastatic breast cancer: Results of DESTINY-Breast04, a randomized, phase 3 study. American Society of Clinical Oncology (ASCO) 2022, 3–5 June 2022.
12. AstraZeneca. Trastuzumab deruxtecan showed significant clinical efficacy in patients with HER2-positive breast cancer and brain metastases. Available at: https://astrazeneca.ru/media/press-releases-for-specialized-media/20241102-ru201. (In Russ.).
Review
For citations:
Murashko R.A., Sharov S.V., Chashnikova E.P. Trastuzumab deruxtecan for the late lines of treatment for HER2-low metastatic breast cancer: a clinical case. Tumors of female reproductive system. 2024;20(4):95-100. (In Russ.) https://doi.org/10.17650/1994-4098-2024-20-4-95-100
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