Clinical case illustrates trastuzumab deruxtecan's efficacy in patients with brain metastases, indicating potential for improved outcomes in HER2-positive breast cancer.
The molecular subtype of breast cancer (BC) associated with overexpression of HER2/neu is characterized by more frequent and early metastasis to the central nervous system, predetermining poor prognosis for patients in this category. Patients with secondary brain lesions due to tumors of any localization and histological structure are the most complex group of patients, with an extremely low level of quality of life and requiring special close monitoring and the development of a personal management algorithm. The introduction of a new drug, trastuzumab deruxtecan (T-DXd) [conjugate of a humanized immunoglobulin G1 antibody to the HER2 receptor and a topoisomerase I inhibitor, an exatecan derivative], as a new therapeutic option is a hope for patients with metastatic BC, including those with central nervous system involvement. The article presents the results of randomized clinical trials that supported these indications and the DESTINY-Breast12 phase IIIb/IV study, demonstrating the high intracranial activity of the drug. A case is presented to illustrate the efficacy of trastuzumab deruxtecan in a patient with HER2-positive (HER2+) metastatic BC with brain metastases.
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Radyukova et al. (2025) studied this question.
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