Trastuzumab deruxtecan (T-DXd) was associated with higher response rates and longer survival than capecitabine-based regimens for third-line treatment of patients with HER2-positive metastatic breast cancer previously treated with trastuzumab emtansine (T-DM1), according to a study presented at the San Antonio Breast Cancer Symposium, held from Dec. 6 to 10.
The trial included 608 patients randomly assigned (2:1) to either T-DXd or TPC (trastuzumab plus capecitabine or lapatinib plus capecitabine). The researchers found that patients had a median of two prior lines of systemic therapy (excluding hormone therapy) in the metastatic setting.
The T-DXd group had a median treatment duration of 11.3 months versus 4.5 months in the TPC arm. T-DXd was associated with significantly improved progression-free survival and overall survival versus TPC. T-DXd had a confirmed overall response rate of 69.7 percent (14 percent complete response) versus 29.2 percent (5.0 percent complete response) with capecitabine-based chemotherapy.
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Hazelgreen
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eye popping good news! Wishing I was Her 2 +. But this is great for all of us to have this much hope. Especially excited about the new herceotin combo having 70% RR vs 29% for the Herceptin / cape arm. That is great news.
i am just moving on from Kadcyla (trastuzumab entansine) because the disease has spread some more in my brain. I'm starting Enhertu on Friday. Is this the same as Enhertu? Or an alternative?
I am HER2- and was given this "infusion" on 11/18. It has been hell since then. I do not believe it was the medication as I did in the beginning. I believe it was the errors of the cancer center I have been going to. I am now in process of reaching out to the FDA (that fast track approved this and the company that makes it.)
I had the infusion and was supposed to wait until 3 pm to have an MRI. I apparently went home. My palliative care doctor I could hear calling me non-stop and hearing fear in her voice. I did not even know I was home but I was on the floor and could not move. My doctor then called the police (who also brought along EMTs) to do a wellness check on me. They had to break down my door and they found me in the bathroom with "blunt head trauma" talking gibberish.
I was then falling non-stop. Never sideways. I fell backwards and hit my head on my hardwood floor several times. Once I fell, I was never able to get up. Two more times, emergency EMTs had to come to my house.
I am now using a walker and to my horror, I have lost all my hair and am now almost 100% bald (I was told minimal hair loss!). I look horrible and now I look very sick. I now have to get at home hospice. You have no idea how angry and upset I am that I went with this treatment.
But from what I am reading, I was NOT a candidate for this. It states patient "should have had chemotherapy previously (I never had chemo, I was diagnosed at stage iv) or the patient should have had surgery where the cancer was gone but then returned. I never had surgery and I have been in treatment for five years.
This treatment has destroyed the good quality of life I was having until the end. Now, everything is different. Like I said, I do NOT think it was the medication. It was the careless sloppiness of the cancer center and my onco. Oh yes, my feet and legs swelled up about five days after this treatment to the point I could not wear shoes. I live alone so not being able to leave my apt., bc I could not wear shoes made things very difficult.
For me, it was and continues to be a horror. I am going to call the FDA again. Never just trust your onco, do a bit of research first.
Wow! That truly does sound like a nightmare! I am very sorry that you experienced this. It seems to me that your cancer center was extremely negligent!
Kearnan, it's so good to hear from you, though I'm sorry about those terrible experiences. Thank you for letting me know about those side effects (though they are a bit scary...) hopefully I will not react like that 🙏. I am glad you are getting some proper help now; things have been tough for you. Wishing you continued courage and things which make you smile xxxxx
According to Breastcancer.Org: "Enhertu is a targeted therapy made up of three parts: fam-trastuzumab: an anti-HER2 medicine that has the same basic structure as Herceptin (chemical name: trastuzumab), a topoisomerase I inhibitor chemotherapy called DXd: topoisomerase I inhibitors work by interfering with cancer cells’ ability to replicate, a compound that links the fam-trastuzumab molecule to the topoisomerase I inhibitor chemotherapy molecule.
Doctors call Enhertu an antibody-drug conjugate targeted therapy. The combination of the topoisomerase I inhibitor and the linking compound is called deruxtecan. The linking compound attaches (conjugates) the fam-trastuzumab to the topoisomerase I inhibitor chemotherapy.
Enhertu is given intravenously, which means the medicine is delivered directly into your bloodstream through an IV or port. Enhertu usually is given every 3 weeks unless the cancer grows or unacceptable side effects develop.
In earlier studies, Enhertu was called T-DXd and DS-8201. Enhertu is approved by the U.S. Food and Drug Administration (FDA) to treat unresectable or metastatic HER2-positive breast cancer that has been previously treated with two or more anti-HER2 treatment regimens. (Unresectable means the cancer can’t be removed with surgery.)"
Great information. What is the resource of this study? I'm wondering what other drugs were used in the treatment. I'd like to bring this to my doctor to make sure we are on the right track. Thank you!
I read about the study in the press release for the San Antonio Breast Cancer Symposium, held from Dec. 6 to 10, 2021. Here's a reference to comments about the study in Oncology:
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Good news? Maybe. 
