Article
Author: Itoh, Mitsuya ; Pernas, Sonia ; Ouyang, Zhong ; Chang, Yuan-Ching ; Hattori, Masaya ; Im, Seock-Ah ; Riaz, Fauzia ; Csőszi, Tibor ; Becourt, Stéphanie ; Inoue, Kenichi ; Guarneri, Valentina ; Pistilli, Barbara ; Barbero, Arturo ; Patel, Ankit ; Moore, Halle ; Denduluri, Neelima ; Domínguez, María Emilia ; Gombos, Andrea ; Kim, Jee Hung ; Jañez, Noelia Martínez ; Blais, Andre ; Tolaney, Sara ; Hardy-Bessard, Anne-Claire ; Biganzoli, Laura ; van de Wouw, Agnès ; Braun, Michael ; Schneeweiß, Andreas ; Stroyakovskiy, Daniil ; Sharma, Lalit ; Ferrario, Cristiano ; Wheatley, Duncan ; Liu, Chien-Ting ; Mathiba, Rofhiwa ; Jassem, Jacek ; Wang, Xiaojia ; Nowecki, Zbigniew ; Beato, Patricia ; Rapoport, Bernardo ; Schmid, Peter ; Comins, Charles ; Gupta, Vineet ; Artamonova, Elena ; Martínez Jañez, Noelia ; Pápai, Zsuzsanna ; Rubovszky, Gábor ; Sun, Meili ; Tokunaga, Eriko ; Park, Yeon Hee ; Konings, Inge ; Asselah, Jamil ; Niikura, Naoki ; Drooger, Jan ; Meattini, Icro ; Sohn, Joo Hyuk ; Wang, Yongsheng ; Ouyang, Quchang ; Xu, Binghe ; Li, Hui ; Chmielowska, Ewa ; Tseng, Ling-Ming ; Ghadyalpatil, Nikhil ; Tong, Zhongsheng ; Aogi, Kenjiro ; Karaszewska, Bogusława ; De Laurentiis, Michelino ; Kwiatkowski, Mariusz ; Bines, José ; Yonemori, Kan ; Punie, Kevin ; Zang, Aimin ; Roy, Somnath ; Shimomura, Akihiko ; Cortés Castán, Javier ; Borges, Giuliano ; Rubini Liedke, Pedro Emanuel ; Jhaveri, Komal ; Saji, Shigehira ; Mekebeb-Reuter, Martha ; Yamashita, Toshinari ; Jerusalem, Guy ; Bianchini, Giampaolo ; Romitelli, Betiana ; Mailliez, Audrey ; Zamagni, Claudio ; Zhang, Zhanmin ; Patel, Niki ; Chen, Shin-Cheh ; Czartoryska-Arłukowicz, Bogumiła ; Jung, Kyung Hae ; Braybrooke, Jeremy ; Michie, Caroline ; Mina, William ; Daniele, Sergio ; Bermejo de las Heras, Begoña ; Villanueva, Cristian ; Wang, Xian ; Bezecny, Pavel ; Park, Kyong Hwa ; Yuan, Yuan ; Cescon, David W. ; McCann, Kelly ; Nagahashi, Masayuki ; Aktas, Bahriye ; Antolín Novoa, Silvia ; Lu, Yen-Shen ; Khan, Sabrina ; Jiménez Rodríguez, Begoña ; Friedmann, Jennifer ; Nakayama, Takahiro ; Wang, Shu ; Lee, Keun Seok ; Yedla, Rajani ; Zhang, Qingyuan ; Ung, Mony ; Borley, Annabel ; Hamilton, Erika ; Testa, Laura ; Pandey, Apurva ; Wang, Jingfen ; Sharma, Richu ; Mukohara, Toru ; Bondarde, Shailesh ; Coccia-Portugal, Maria ; Rapatoni, Liane ; Garbay, Delphine ; Trivedi, Sachin ; Kalinka, Ewa ; Rugo, Hope S. ; De Giorgi, Ugo ; Chen, Wenyan ; Wang, Shusen ; Yao, Tingjing ; Vander Woude, Amy ; Borrego, Manuel Ruiz ; Geuna, Elena ; Paris, Ida ; Wright, Gail ; Mortimer, Joanne ; Pinczowski, Helio ; Colleoni, Marco ; Radosa, Julia ; Chung, Wei-Pang ; Venkatesha, Chandrakanth Mosale ; Kalinsky, Kevin ; Kawaguchi, Nobuko ; Iwasa, Tsutomu ; Yu, Joanne ; Adamo, Barbara ; Decker, Thomas ; Ostoich, Sandra Anabel ; Jardim, Debora ; McGrath, Sophie ; Danielewicz, Iwona ; Bardia, Aditya ; Schoeman, Elizabeth ; Korbenfeld, Ernesto ; Bayo Calero, Juan Lucas ; Galve Calvo, Elena ; Sheng, Yuan ; Watanabe, Kenichi ; Bachelot, Thomas ; Taira, Tetsuhiko ; Montemurro, Filippo ; Tsurutani, Junji ; Wang, Hwei-Chung ; Xu, Lu ; García Sáenz, José Ángel ; Buono, Cristian ; Ozaki, Yukinori ; Jiang, ZeFei ; Ross, Masey ; O'Brien, Ciara ; Rau, Kun-Ming ; Rosselli, Geronimo ; Collignon, Joëlle ; Wildiers, Hans ; Al-Farhat, Yousuf ; Cesca, Marcelle ; Mukesh, Mukesh ; Karim, Syed ; Fairhurst, Rick M. ; Li, Wei
PURPOSEThe global, phase 3, open-label, randomized TROPION-Breast01 study assessed the trophoblast cell surface antigen 2–directed antibody-drug conjugate datopotamab deruxtecan (Dato-DXd) versus investigator's choice of chemotherapy (ICC) in hormone receptor–positive/human epidermal growth factor receptor 2–negative (HR+/HER2–) breast cancer.METHODSAdult patients with inoperable/metastatic HR+/HER2‒ breast cancer, who had disease progression on endocrine therapy, for whom endocrine therapy was unsuitable, and had received one to two previous lines of chemotherapy in the inoperable/metastatic setting, were randomly assigned 1:1 to Dato-DXd (6 mg/kg once every 3 weeks) or ICC (eribulin/vinorelbine/capecitabine/gemcitabine). Dual primary end points were progression-free survival (PFS) by blinded independent central review (BICR) and overall survival (OS).RESULTS
Patients were randomly assigned to Dato-DXd (n = 365) or ICC (n = 367). Dato-DXd significantly reduced the risk of progression or death versus ICC (PFS by BICR hazard ratio [HR], 0.63 [95% CI, 0.52 to 0.76];
P
< .0001). Consistent PFS benefit was observed across subgroups. Although OS data were not mature, a trend favoring Dato-DXd was observed (HR, 0.84 [95% CI, 0.62 to 1.14]). The rate of grade ≥3 treatment-related adverse events (TRAEs) with Dato-DXd was lower than ICC (20.8%
v
44.7%). The most common TRAEs (any grade; grade ≥3) were nausea (51.1%; 1.4%) and stomatitis (50%; 6.4%) with Dato-DXd and neutropenia (grouped term, 42.5%; 30.8%) with ICC.
CONCLUSIONPatients receiving Dato-DXd had statistically significant and clinically meaningful improvement in PFS and a favorable and manageable safety profile, compared with ICC. Results support Dato-DXd as a novel treatment option for patients with inoperable/metastatic HR+/HER2‒ breast cancer who have received one to two previous lines of chemotherapy in this setting.