How is DESTINY-Breast09 changing the first-line treatment landscape for metastatic HER2-positive breast cancer?
Drs. Jason Mouabbi and Neil Iyengar discuss the evolving role of trastuzumab deruxtecan (T-DXd) plus pertuzumab in first-line metastatic HER2-positive breast cancer and how the DESTINY-Breast09 findings are influencing clinical decision-making.
They examine how this approach compares with the long-standing CLEOPATRA regimen, why depth and duration of response matter, and how clinicians can balance efficacy, tolerability, maintenance strategies, and future treatment sequencing when individualizing care.
Topics discussed:
- The HER2-positive metastatic breast cancer landscape before DESTINY-Breast09
- How DESTINY-Breast09 compared T-DXd plus pertuzumab with the CLEOPATRA regimen
- Progression-free survival and the clinical implications of the DB-09 results
- Why using the most active therapies earlier may influence treatment outcomes
- Complete response and the emerging concept of deep partial response
- How treatment duration may affect depth of response with T-DXd plus pertuzumab
- Treatment considerations for patients with PIK3CA-mutated HER2-positive disease
- Managing T-DXd-associated nausea and the role of proactive antiemetic therapy
- ILD monitoring, including kidney function, and rechallenge following grade 1 ILD
- Cardiac monitoring during HER2-directed therapy
- Where PATINA and HER2CLIMB-05 maintenance fit
- Treatment options after progression on first-line T-DXd plus pertuzumab
- The potential role of rebiopsy and changes in HER2 expression after T-DXd
- How prior neoadjuvant or adjuvant T-DXd may influence treatment at metastatic recurrence
▶️ Watch the full CHM Conversation for expert perspectives on applying evolving HER2-positive breast cancer evidence to clinical practice.
#JasonMouabbi #NeilIyengar #CHMConversations #HER2PositiveBreastCancer #MetastaticBreastCancer #BreastCancer #TDXd #TrastuzumabDeruxtecan #DESTINYBreast09 #CommunityHealthMedia
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