Metastasised breast cancer: Are there new treatment options?

In breast cancer, metastases may occur in body areas not always easy to treat. But there are two new treatment options for these patients.

New treatment options for metastatic breast cancer

• The antibody conjugate trastuzumab deruxtecan (T-DXd) is associated with a good intracranial response in brain metastases.
• Progression-free survival in terms of CNS involvement was significantly longer with T-DXd than with the control group.
• Longer survival times were also achieved for leptomeningeal carcinomatosis.
• Datopotamab deruxtecan (Dato-DXd) is an effective therapy for hormone receptor-positive advanced breast carcinomas.

New treatment strategies for brain metastases

Advanced breast carcinomas can spread to almost all parts of the body, particularly frequently to the CNS. The treatment of brain metastases is often difficult and complex. However, there is a new treatment option that has significantly improved progression-free survival and the overall response rate for existing metastases in the brain in studies: the antibody conjugate trastuzumab deruxtecan (T-DXd).

What results are possible with T-DXd?

There are several studies that support the favourable outcomes with T-DXd:

• For example, longer progression-free survival was achieved in terms of CNS involvement, both for active and stabilised metastases. People treated with T-DXd had a CNS PFS of 12.3 (stabilised metastases) and 18.5 (active metastases) months, compared to 8.7 and 4.0 months in the comparator group.
• T-DXd led to a good intracranial response and ORR.
• The intracranial response time was around one year. 
• The results can also be reproduced for patients with leptomeningeal carcinomatosis - an unprecedented success.

What about other metastases?

There is also a new treatment option for patients with HR+/HER2- breast cancer. In studies, the antibody-drug conjugate Datopotamab Deruxtecan (Dato-DXd), which is directed against trophoblast cell surface antigen-2, showed improved outcomes compared to existing chemotherapies. Patients who received this drug achieved a longer PFS and a clinically-relevant increase in ORR. The safety profile did not show any new features and patients had fewer severe side effects overall than with conventional chemotherapies.

Hope through promising results

There are new treatment options for patients with advanced breast cancer that lead to longer PFS and improved outcomes. Particularly for patients with brain metastases, new approaches are available that are associated with a good response. With Dato-DXd, a new treatment pathway is also available for metastasised hormone receptor-positive forms of breast cancer, which has achieved promising results in studies.