T-DXd Improves Residual Cancer Burden in HER2-Positive Early Breast Cancer
Clinical Summary:
- Design/Context: The phase 3 DESTINY-Breast11 trial compared neoadjuvant T-DXd-based regimens against standard chemotherapy in high-risk HER2-positive early breast cancer.
- Key Outcomes: T-DXd-containing regimens increased pathologic complete response rates and shifted residual cancer burden toward lower values across the spectrum of non-pCR patients.
- Clinical Relevance: Lower residual cancer burden is associated with improved prognosis, supporting T-DXd–based regimens as a highly active neoadjuvant option while event-free survival data continue to mature.
Lajos Pusztai, MD, DPhil, Yale Cancer Center, New Haven, Connecticut, discusses post hoc analysis results from the of the phase 3 DESTINY-Breast11 trial assessing neoadjuvant trastuzumab deruxtecan (T-DXd) plus paclitaxel, trastuzumab, and pertuzumab in patients with HER2-positive early breast cancer.
Results demonstrated that this combination improved residual cancer burden compared with dose-dense doxorubicin and cyclophosphamide plus paclitaxel, trastuzumab, and pertuzumab.
Dr Pusztai presented these results at the 2026 European Society for Medical Oncology (ESMO) Breast Cancer Congress in Berlin, Germany.
Source:
Pusztai L. Residual cancer burden (RCB) following neoadjuvant treatment (NAT) with trastuzumab deruxtecan (T-DXd) followed by paclitaxel + trastuzumab + pertuzumab (THP) vs dose-dense doxorubicin + cyclophosphamide followed by THP (ddAC-THP) in high-risk HER2+ early-stage breast cancer (eBC). Presented at European Society for Medical Oncology (ESMO) Breast Cancer Congress; March 6 - 8, 2026; Berlin, Germany. LBA1.
