HER3-DXd shows promise for CNS metastases in breast and lung cancer in the TUXEDO-3 trial, including patients with LMD. Dr. Lustberg discusses DESTINY-Breast09 and the potential shift to T-DXd + pertuzumab in HER2+ mBC first-line treatment. Stephanie Graff, MD, reviews top ASCO25 breast cancer trials, including ASCENT-04, DESTINY-Breast09, and SERENA-6.
Dr. Gradishar discusses how tolerability, toxicity, and NCCN guidelines shape HER2+ breast cancer treatment decisions.
Dr. William Gradishar discusses treatment sequencing strategies for HER2+ metastatic breast cancer at ASCO 2025. T-DXd plus pertuzumab significantly improves PFS vs THP in HER2+ mBC, per interim results from DESTINY-Breast09. THP delivers similar pCR and better tolerability than TCbHP for HER2+ early breast cancer, per phase 3 neoCARHP trial. T-DXd improves PFS and cORR over chemo in HER2-low/ultralow HR+ mBC, regardless of PI3K, ESR1, or BRCA1/2 mutations. T-DXd rechallenge after grade 1 ILD showed high success and prolonged benefit, with low recurrence and no grade 5 events. Trastuzumab rezetecan shows strong intracranial activity in HER2+ breast cancer with brain metastases in REIN trial. Zanidatamab plus chemo showed promising responses in HER2+ and HER2-low mBC, with durable activity in a phase I trial. Higher fat mass and lower fat density linked to increased T-DXd dose reductions and toxicity in metastatic breast cancer. Pembrolizumab plus dual HER2 blockade may offer a chemo-free option for early HER2+ breast cancer, phase 2 data suggest. Enhertu plus THP improved pCR over standard chemo in high-risk HER2+ early breast cancer, DESTINY-Breast11 shows.
New staging model links treatment response to survival, refining breast cancer prognosis after neoadjuvant chemotherapy. A new AJCC model refines breast cancer staging after neoadjuvant chemo, filling a key gap in patient prognostication. Dr. Soliman explores dendritic cell vaccines to boost immunity and cut chemo toxicity in early HER2-positive breast cancer. Pilot study shows HER2-targeted dendritic cell vaccines may enhance immune response in early HER2-positive breast cancer. Dr. Nunnery weighs IV Enhertu vs oral chemo, highlighting how patient goals and QoL shape treatment decisions. Dr. Nunnery discusses HER2-low and ultralow testing and Enhertu’s role after DESTINY-Breast06 in metastatic breast cancer.