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CC BY-NC-ND 4.0 · Indian J Med Paediatr Oncol 2019; 40(04): 556-558
DOI: 10.4103/ijmpo.ijmpo_264_19
Drug Review

Trastuzumab Deruxtecan: A Quantum Leap in HER2‑Positive Breast Cancer

Manikandan Dhanushkodi
Department of Medical Oncology, Cancer Institute (WIA), Chennai, Tamil Nadu, India
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Abstract

Docetaxel, trastuzumab, and pertuzumab, known as THP, is the preferred first-line treatment for HER2-positive advanced breast cancer, and the second-line drug of choice is trastuzumab emtansine. Most patients eventually develop resistance to systemic therapy. Trastuzumab deruxtecan, a novel HER2-targeted antibody drug conjugate, has shown to be promising in this subset. It is a HER2-targeted antibody drug conjugate structurally composed of humanized anti-HER2 monoclonal antibody, cleavable tetra-peptide-based liker, and a potent payload (topoisomerase 1 inhibitor: Exatecan). A phase 2 trial of heavily pretreated advanced HER2-positive breast cancer (median of six lines of prior therapy) showed an overall response of 61% and a median progression-free survival of 16 months. In December 2019, the Food and Drug Administration announced accelerated approval of trastuzumab deruxtecan for HER2-positive advanced breast cancer patients who were prior exposed to two or more lines of anti-HER2 therapy in a metastatic setting.

Keywords

Advanced breast cancer - HER2 positive - trastuzumab deruxtecan


Publication History

Received: 23 December 2019

Accepted: 03 January 2020

Article published online:
03 June 2021

© 2020. Indian Society of Medical and Paediatric Oncology. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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