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Yara Abdou, MD
The phase 3 DESTINY-Breast03 trial evaluated trastuzumab deruxtecan vs ado-trastuzumab emtansine (T-DM1) in 524 patients with unresectable or metastatic human epidermal growth factor receptor 2–positive (HER2+) breast cancer (BC) previously treated with trastuzumab and a taxane. Results showed that trastuzumab deruxtecan improved survival outcomes compared with trastuzumab emtansine, with median progression-free survival (PFS) of 28.8 months vs 6.8 months (hazard ratio [HR] 0.33 [95% CI 0.26-0.43]; P < .0001). Median overall survival (OS) was not reached in either cohort, with 72 (28%) OS events in the trastuzumab deruxtecan group vs 97 (37%) in the trastuzumab emtansine group (HR 0.64; 95% CI 0.47–0.87]; P = .0037). A manageable safety profile was reported, with a similar number of grade 3 or worse treatment-related adverse events in patients who received trastuzumab deruxtecan vs trastuzumab emtansine (56% vs 52%). Drug-related interstitial lung disease occurred in 15% of patients treated with trastuzumab deruxtecan vs 3% of patients treated with trastuzumab emtansine, with no grade 4 or 5 events in either group.

This is the longest reported median PFS in HER2+ metastatic BC, highlighting the potential of trastuzumab deruxtecan in treating this disease and confirming this drug as the standard of care in the second-line setting.

A cohort study evaluated 315 postmenopausal BC survivors to estimate the association of physical activity with risk for all-cause mortality. Participants were queried about leisure-time physical activity using the Godin-Shephard Leisure-Time Physical Activity Questionnaire (GSLTPAQ), which provided a composite score that categorized exercise patterns as active, moderately active, or insufficiently active at baseline.

Results showed that participants who were active or moderately active had a 60% decreased risk for death compared with insufficiently active participants (active: HR 0.42 [95% CI 0.21-0.85]; moderately active: HR 0.40 [95% CI 0.17-0.95]). A similar mortality risk was reported among participants who were active and those with moderate physical activity levels.

Prior studies1 have reported similar results, reaffirming the value of exercise in BC survivors and highlighting the need to incorporate physical activity as part of survivorship care plans.

The phase 3 SOPHIA study randomized 536 patients with HER2+ advanced BC who had received two or more prior anti-HER2 regimens to margetuximab plus chemotherapy vs trastuzumab plus chemotherapy. Final OS results after a median follow-up of 20.2 months showed no benefit in OS observed with margetuximab vs trastuzumab (median OS 21.6 months vs 21.9 months; HR 0.95; P = .620). The safety profile of margetuximab was acceptable and comparable to that of trastuzumab. Exploratory analysis of CD16A genotyping suggested a possible improvement in OS for margetuximab in CD16A-158FF patients vs trastuzumab (median OS 23.6 vs 19.2 months; HR 0.72; 95% CI 0.52-1.00) and a possible improvement in OS for trastuzumab in CD16A-158VV patients vs margetuximab (median OS 31.1 vs 22.0 months; HR 1.77; 95% CI 1.013.12). The safety profile of margetuximab was acceptable and comparable to that of trastuzumab. Further studies to evaluate the role of margetuximab in patients with HER2+ BC with different CD16A allelic variants are warranted.

Additional References

Cannioto RA, Hutson A, Dighe S, et al. Physical activity before, during, and after chemotherapy for high-risk breast cancer: Relationships with survival.  J Natl Cancer Inst. 2021;113:54-63. Doi:10.1093/jnci/djaa046

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Yara Abdou, MD
Breast Medical Oncologist
Assistant Professor, Division of Oncology
University of North Carolina at Chapel Hill
Lineberger Comprehensive Cancer Center

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Author and Disclosure Information

Yara Abdou, MD
Breast Medical Oncologist
Assistant Professor, Division of Oncology
University of North Carolina at Chapel Hill
Lineberger Comprehensive Cancer Center

Author and Disclosure Information

Yara Abdou, MD
Breast Medical Oncologist
Assistant Professor, Division of Oncology
University of North Carolina at Chapel Hill
Lineberger Comprehensive Cancer Center

Yara Abdou, MD
The phase 3 DESTINY-Breast03 trial evaluated trastuzumab deruxtecan vs ado-trastuzumab emtansine (T-DM1) in 524 patients with unresectable or metastatic human epidermal growth factor receptor 2–positive (HER2+) breast cancer (BC) previously treated with trastuzumab and a taxane. Results showed that trastuzumab deruxtecan improved survival outcomes compared with trastuzumab emtansine, with median progression-free survival (PFS) of 28.8 months vs 6.8 months (hazard ratio [HR] 0.33 [95% CI 0.26-0.43]; P < .0001). Median overall survival (OS) was not reached in either cohort, with 72 (28%) OS events in the trastuzumab deruxtecan group vs 97 (37%) in the trastuzumab emtansine group (HR 0.64; 95% CI 0.47–0.87]; P = .0037). A manageable safety profile was reported, with a similar number of grade 3 or worse treatment-related adverse events in patients who received trastuzumab deruxtecan vs trastuzumab emtansine (56% vs 52%). Drug-related interstitial lung disease occurred in 15% of patients treated with trastuzumab deruxtecan vs 3% of patients treated with trastuzumab emtansine, with no grade 4 or 5 events in either group.

This is the longest reported median PFS in HER2+ metastatic BC, highlighting the potential of trastuzumab deruxtecan in treating this disease and confirming this drug as the standard of care in the second-line setting.

A cohort study evaluated 315 postmenopausal BC survivors to estimate the association of physical activity with risk for all-cause mortality. Participants were queried about leisure-time physical activity using the Godin-Shephard Leisure-Time Physical Activity Questionnaire (GSLTPAQ), which provided a composite score that categorized exercise patterns as active, moderately active, or insufficiently active at baseline.

Results showed that participants who were active or moderately active had a 60% decreased risk for death compared with insufficiently active participants (active: HR 0.42 [95% CI 0.21-0.85]; moderately active: HR 0.40 [95% CI 0.17-0.95]). A similar mortality risk was reported among participants who were active and those with moderate physical activity levels.

Prior studies1 have reported similar results, reaffirming the value of exercise in BC survivors and highlighting the need to incorporate physical activity as part of survivorship care plans.

The phase 3 SOPHIA study randomized 536 patients with HER2+ advanced BC who had received two or more prior anti-HER2 regimens to margetuximab plus chemotherapy vs trastuzumab plus chemotherapy. Final OS results after a median follow-up of 20.2 months showed no benefit in OS observed with margetuximab vs trastuzumab (median OS 21.6 months vs 21.9 months; HR 0.95; P = .620). The safety profile of margetuximab was acceptable and comparable to that of trastuzumab. Exploratory analysis of CD16A genotyping suggested a possible improvement in OS for margetuximab in CD16A-158FF patients vs trastuzumab (median OS 23.6 vs 19.2 months; HR 0.72; 95% CI 0.52-1.00) and a possible improvement in OS for trastuzumab in CD16A-158VV patients vs margetuximab (median OS 31.1 vs 22.0 months; HR 1.77; 95% CI 1.013.12). The safety profile of margetuximab was acceptable and comparable to that of trastuzumab. Further studies to evaluate the role of margetuximab in patients with HER2+ BC with different CD16A allelic variants are warranted.

Additional References

Cannioto RA, Hutson A, Dighe S, et al. Physical activity before, during, and after chemotherapy for high-risk breast cancer: Relationships with survival.  J Natl Cancer Inst. 2021;113:54-63. Doi:10.1093/jnci/djaa046

Yara Abdou, MD
The phase 3 DESTINY-Breast03 trial evaluated trastuzumab deruxtecan vs ado-trastuzumab emtansine (T-DM1) in 524 patients with unresectable or metastatic human epidermal growth factor receptor 2–positive (HER2+) breast cancer (BC) previously treated with trastuzumab and a taxane. Results showed that trastuzumab deruxtecan improved survival outcomes compared with trastuzumab emtansine, with median progression-free survival (PFS) of 28.8 months vs 6.8 months (hazard ratio [HR] 0.33 [95% CI 0.26-0.43]; P < .0001). Median overall survival (OS) was not reached in either cohort, with 72 (28%) OS events in the trastuzumab deruxtecan group vs 97 (37%) in the trastuzumab emtansine group (HR 0.64; 95% CI 0.47–0.87]; P = .0037). A manageable safety profile was reported, with a similar number of grade 3 or worse treatment-related adverse events in patients who received trastuzumab deruxtecan vs trastuzumab emtansine (56% vs 52%). Drug-related interstitial lung disease occurred in 15% of patients treated with trastuzumab deruxtecan vs 3% of patients treated with trastuzumab emtansine, with no grade 4 or 5 events in either group.

This is the longest reported median PFS in HER2+ metastatic BC, highlighting the potential of trastuzumab deruxtecan in treating this disease and confirming this drug as the standard of care in the second-line setting.

A cohort study evaluated 315 postmenopausal BC survivors to estimate the association of physical activity with risk for all-cause mortality. Participants were queried about leisure-time physical activity using the Godin-Shephard Leisure-Time Physical Activity Questionnaire (GSLTPAQ), which provided a composite score that categorized exercise patterns as active, moderately active, or insufficiently active at baseline.

Results showed that participants who were active or moderately active had a 60% decreased risk for death compared with insufficiently active participants (active: HR 0.42 [95% CI 0.21-0.85]; moderately active: HR 0.40 [95% CI 0.17-0.95]). A similar mortality risk was reported among participants who were active and those with moderate physical activity levels.

Prior studies1 have reported similar results, reaffirming the value of exercise in BC survivors and highlighting the need to incorporate physical activity as part of survivorship care plans.

The phase 3 SOPHIA study randomized 536 patients with HER2+ advanced BC who had received two or more prior anti-HER2 regimens to margetuximab plus chemotherapy vs trastuzumab plus chemotherapy. Final OS results after a median follow-up of 20.2 months showed no benefit in OS observed with margetuximab vs trastuzumab (median OS 21.6 months vs 21.9 months; HR 0.95; P = .620). The safety profile of margetuximab was acceptable and comparable to that of trastuzumab. Exploratory analysis of CD16A genotyping suggested a possible improvement in OS for margetuximab in CD16A-158FF patients vs trastuzumab (median OS 23.6 vs 19.2 months; HR 0.72; 95% CI 0.52-1.00) and a possible improvement in OS for trastuzumab in CD16A-158VV patients vs margetuximab (median OS 31.1 vs 22.0 months; HR 1.77; 95% CI 1.013.12). The safety profile of margetuximab was acceptable and comparable to that of trastuzumab. Further studies to evaluate the role of margetuximab in patients with HER2+ BC with different CD16A allelic variants are warranted.

Additional References

Cannioto RA, Hutson A, Dighe S, et al. Physical activity before, during, and after chemotherapy for high-risk breast cancer: Relationships with survival.  J Natl Cancer Inst. 2021;113:54-63. Doi:10.1093/jnci/djaa046

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