A new therapeutic combination has proven to be more effective than the first standard treatment currently used for metastatic HER2+ breast cancer after diagnosis. These are the results of the phase 3 Destiny-Bresat09 clinical trial, published in The New England Journal of Medicine, in which scientists from the Vall d'Hebron Institute of Oncology (VHIO) in Spain participated. 'This study changes the treatment for HER2+ breast cancer, which accounts for 20% of metastatic breast cancer cases,' EFE highlighted Cristina Saura, head of the VHIO's Breast Cancer Group, who is part of the study's steering committee. Researchers have demonstrated that the combination of the drug trastuzumab deruxtecan, along with pertuzumab, improves progression-free survival (when the tumor is not growing and is controlled) by 44% when applied as a first-line treatment (as the first option after diagnosis), compared to the current standard treatment, which consists of chemotherapy and a combination of two antibodies. The antibody-drug conjugate trastuzumab deruxtecan is specifically designed for HER2 and is approved in Spain for some second-line indications in metastatic breast cancer treatment. The novelty is that this study shows that instead of keeping it as a second-line option, it is better to apply it as a first-line treatment after diagnosis. 'In oncology, using the most active drugs as early as possible is usually better for patients,' stated Saura. That the study demonstrates that this combination improves disease control is sufficient for oncologists to place it as a first-line treatment, although the impact on overall survival—i.e., how long the period in which patients remain alive is extended in the long term—remains to be seen, Saura noted. The treatment will soon be available to patients Saura said that since the drugs were previously approved for breast cancer, they can be offered to patients more quickly, by the end of this year. Furthermore, administration will be accompanied by a series of digital tools to monitor adverse side effects (toxicity control). These tools are part of the TOP-REAL project, led by the Solti clinical breast cancer research group, of which Saura is a part. The launch of TOP-REAL was made possible by Chorus, one of the initiatives of the Daiichi Sankyo-AstraZeneca alliance, in which VHIO participates as the Spanish representative.
