Trastuzumab deruxtecan ups PFS in HER2+ metastatic breast cancer (216% more people alive with no progression at 12 months over using trastuzumab emtansine)

Medical Xpress / New England Journal of Medicine ^ | Mar. 24, 2022 | Javier Cortés, M.D., Ph.D. et al

[ConservativeMind]

For patients with human epidermal growth factor receptor 2 (HER2)-positive metastatic breast cancer previously treated with trastuzumab and a taxane, the risk of progression or death from any cause is lower with trastuzumab deruxtecan versus trastuzumab emtansine, according to a study published in the March 24 issue of the New England Journal of Medicine.

Javier Cortés, M.D., Ph.D., from the International Breast Cancer Center in Barcelona, Spain, and colleagues conducted a phase 3, open-label trial to compare the efficacy and safety of trastuzumab deruxtecan (a HER2 antibody-drug conjugate) with trastuzumab emtansine in 524 patients with HER2-positive metastatic breast cancer who had previously been treated with trastuzumab and a taxane.

The researchers found that the percentage of patients who were alive without disease progression at 12 months was 75.8 and 34.1 percent with trastuzumab deruxtecan and trastuzumab emtansine, respectively (hazard ratio for progression or death from any cause, 0.28). The corresponding percentage of patients who were alive at 12 months was 94.1 and 85.9 percent (hazard ratio for death, 0.55; prespecified significance boundary not reached). An overall response occurred in 79.7 and 34.2 percent of the patients, respectively. The incidence of grade 3 or 4 drug-related adverse events was 45.1 and 39.8 percent, respectively; adjudicated drug-related interstitial lung disease or pneumonitis occurred in 10.5 and 1.9 percent of patients in the trastuzumab deruxtecan and trastuzumab emtansine groups, respectively.

"Trastuzumab deruxtecan is an effective new treatment for patients with HER2-positive metastatic breast cancer who have been previously treated with trastuzumab and a taxane, as well as with pertuzumab when available," the authors write.

[ConservativeMind]

Metastatic breast cancer that’s been previously and unsuccessfully treated has very little left available to address it. It looks like this newer drug does a good job of helping, but it also has over 500% more likelihood (10.5% of all recipients) of causing a major lung illness that then needs to be treated.

The medicine is available today.

[ConservativeMind]

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[ConservativeMind]

“The incidence of grade 3 or 4 drug-related adverse events was 45.1 and 39.8 percent…”

Grade 3 drug side effects are not life threatening.

Grade 4 side effects are life threatening.

[allendale]

Ultimately cancer will be cured with immunotherapy. Cancer cells have developed sophisticated afferent and efferent defenses against the host’s immune system. The solution for treating cancer is permeating and rendering ineffective those defense mechanisms.

[null and void]

Soon to be banned by the FDA...