How will you approach treatment sequencing and use of trastuzumab deruxtecan in hormone receptor-negative, HER2-low breast cancer?

Results from the DESTINY-Breast04 (DB4) trial [1] has created a new therapeutic option for patients with triple negative breast cancer (TNBC) that is low HER2 expressing (IHC 1+ or 2+ but FISH negative). In the DB4 trial, only 11% of participants had hormone receptor negative, HER2 low breast cancer...

Based on results from the DESTINY-Breast04 trial and the ASCENT trial, both T-DXd and Sacituzumab vedotin are good options for patients with HER2-low breast cancer who had at least 1 line of prior chemotherapies for advanced disease. I don’t have reservations about T-DXd in hormone receptor negative...

In the DESTINY-Breast04 trial, participants had all received one to two lines of prior therapy for metastatic disease so currently, this is the setting in which we are typically recommending trastuzumab deruxtecan at our institution. For patients with hormone receptor-negative, HER2-low disease, sac...

I believe both T-DXd and sacituzumab-govitecan are equally reasonable options for hormone receptor-negative, Her 2-low breast cancer. I would individualize treatment based on the side-effects profile of each drug. It would be reasonable to prioritize sacituzumab-govitecan in patients that are consid...