Trastuzumab deruxtecan plus pertuzumab demonstrated a significantly lower risk of progression or death compared to the THP regimen as a first-line treatment for HER2-positive metastatic breast cancer. Patients also had improved response rates and longer progression-free survival with a comparable safety profile.
Study
|
Phase 3, multinational, randomized trial [DESTINY-Breast09] |
| HER2-positive advanced or metastatic breast cancer; no previous chemo or HER2 therapy for metastatic disease |
| Trastuzumab deruxtecan+pertuzumab (n=383) vs THP (n=387)
|
Efficacy
|
ORR: 85.1% vs 78.6% |
| CR: 15.1% vs 8.5% |
| mPFS: 40.7 mos vs 26.9 mos (HR 0.56 [0.44-0.71])
|
Safety
|
Grade >=3 AE: neutropenia (23.9% vs 33.2%), anemia (8.4% vs 3.7%), hypokalemia (10.2% vs 1.6%) |
| Interstitial lung disease or pneumonitis: 12.1% (grade 5: 0.5%) vs 1.0% |
| Discontinuations due to AEs: 20.7% vs 28.3%
|
N Engl J Med. Published online October 29, 2025
http://doi.org/10.1056/NEJMoa2508668
Reviewed by Ulas D. Bayraktar, MD on Nov 17, 2025
