– At the congress in San Antonio, the results of research in HER2 positive breast cancer were presented. They confirmed the role of trastuzumab derukstecan in the treatment. It has been shown that it extends the overall survival time in patients who received this drug in the treatment of metastatic breast cancer in the second line of treatment - said in an interview with Medexpress Dr. Agnieszka Jagiełło-Gruszfeld, head of the conservative department of the Breast Cancer and Reconstructive Surgery Clinic in National Institute of Oncology.
Dr Agnieszka Jagiełło-Gruszfeld: Trastuzumab derukstecan has a chance to be used on a large scale in the treatment of breast cancer
Published Dec. 15, 2022 11:37
The congress in San Antonio has recently ended. This is probably the most important event dedicated to breast cancer. Are there any interesting, hopeful reports from there?
Yes, there has been a lot of talk about trastuzumab deruxtekan, which is now recommended for the treatment of HER2+ breast cancer. The results of the research were also shown in the so-called HER2-low cancer, which has not yet been considered for treatment with anti-HER2 drugs. The concept of HER2 low cancer has appeared recently, because we have been talking about it for about two years. This is a subtype in which estrogen receptors are present or absent, and the HER receptor is 1 or 2 plus, but with a negative FISH result. So far, these cancers have been treated completely differently, but suddenly it turned out that the conjugate trastuzumab derukstecan is also effective in this biological subtype, and much more than chemotherapy. This was a big surprise for many oncologists, because such good results were not expected. It should also be emphasized that this conjugate is much less toxic than traditional chemotherapy. I think this research could make a big revolution in the treatment of HER2-low breast cancer. In addition, the results of tests in HER2 positive breast cancer are shown. They confirmed the role of trastuzumab derukstecan in the treatment. It has been shown to prolong overall survival in patients who received the drug for second-line treatment of metastatic breast cancer. These patients were previously treated with trastuzumab emtansine and also received pertuzumab and trastuzumab. These are very encouraging results. This drug has a chance to be used on a large scale. It was also emphasized that trials in the first line of HER2+ treatment of breast cancer are underway, so perhaps this drug will be the starting point for the treatment of this biological subtype.
How much survival improvement was recorded?
It's practically double the length. HER2+ breast cancer is a subtype in which patients have had long overall survivals so far. HER2+ metastatic breast cancer is believed to have the longest survival rate of all currently recognized biological subtypes. These results are encouraging because it is known that quality of life and time to progression are also important measures of the effectiveness of various therapies in oncology, but the most important thing is actually prolongation of survival time.
What is the response rate to this treatment?
The response to this therapy has been shown to be significantly higher than conventional chemotherapy. In HER2+ cancer, the results were compared to capecitabine-based therapy, previously routinely used.
What is the availability of trastuzumab derukstecan now?
Several clinical trials are being conducted in Poland. They concern HER2+ breast cancer with metastases to the central nervous system or in the second line of treatment. There are also studies in a group of patients with HER2-low cancer. They are conducted in different centers. I think that when it comes to HER2+ breast cancer, these results are mature enough to convince the Ministry of Health to reimburse this preparation. It is by far the most effective drug in this biological subtype right now.
Thank you for the interview.
