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This is one of the most important presentations of the ASCO (American society of clinical onconlogy) congress which is being held in Chicago in the United States this weekend. It concerns the treatment of breast cancer, trastuzumab deruxtecan or Enhertu, which would double the survival of women with HER-low breast cancer. The explanations of Pr Jacques Medioni, medical oncologist at the European Georges-Pompidou Hospital.
Developed by the Daiichi Sankyo and AstraZeneca laboratories, trastuzumab deruxtecan – also known as Enhertu – was evaluated in a phase 3 clinical study including sick patients affected by a particular breast cancer.
A clinical trial on specific patients
Called Destiny – Breast04, this clinical trial involved 557 patients in Asia, Europe and North America with HR-negative or HR-positive, HER2 low, unresectable and/or metastatic breast cancer.
“These patients have the common characteristic of presenting the same type of cancer, namely a cancer which weakly expresses the HER receptor, and which is called HER-low cancer.“says Professor Medioni first of all. “They represent a total of approximately 40 to 50% of breast cancers, which is not negligible.
A 36% reduction in the risk of death
The study therefore compared women treated with simple chemotherapy against those treated with trastuzumab deruxtecan. The latter reduced the risk of disease progression or death compared with chemotherapy in certain patients with HER-low metastatic breast cancer, ie weakly expressing HER receptors.
“Trastuzumab deruxtecan demonstrated clinically meaningful progression-free survival and overall survival. The positive results were for previously treated patients with unresectable and/or metastatic HER2-low breast cancer with HR-positive or HR-negative disease compared to chemotherapy.” says the press release.
After a median follow-up of 18.4 months, HR+ patients who received trastuzumab deruxtecan had:
- A 49% reduction in the risk of cancer progression and a 36% reduction in the risk of death compared to those who received standard chemotherapy;
- Progression-free survival, the time the tumor was stable or shrank, of 10.1 months compared to 5.4 months for those who received standard chemotherapy;
- An overall survival of 23.9 months against 17.5 months for those who received standard chemotherapy.
Cancer drugs: promising figures
“The results of this study showed a 50% reduction in the risk of recurrence, which is enormous. !” enthuses Professor Jacques Medioni. Indeed, the average survival after treatment has increased to 10.1 months compared to 5.4 months with chemotherapy.
“The toxicity of this drug continues to be monitored, particularly on the pulmonary level, but for the rest it is not superior to that of chemotherapy, it seems. adds the doctor. “There is a drop in white blood cells, nausea, hair loss… for nine out of ten patients. This is a major step forward that will radically change the care of these women, it was truly the big announcement of this congress” adds the specialist.
The treatment is currently awaiting marketing authorization for this category of patients, but will, according to Pr Medioni, “available for some patients quickly, thanks to the early access program”, which must be requested by hospital doctors for patients who need it.