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Indian Journal of Medical and Paediatric Oncology
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DRUG REVIEW
Year : 2019  |  Volume : 40  |  Issue : 4  |  Page : 556-558

Trastuzumab deruxtecan: A quantum leap in HER2-positive breast cancer


Department of Medical Oncology, Cancer Institute (WIA), Chennai, Tamil Nadu, India

Correspondence Address:
Dr. Manikandan Dhanushkodi
Department of Medical Oncology, Cancer Institute (WIA), 38 Sardar Patel Road, Chennai - 600 036, Tamil Nadu
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijmpo.ijmpo_264_19

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Docetaxel, trastuzumab, and pertuzumab, known as THP, is the preferred first-line treatment for HER2-positive advanced breast cancer, and the second-line drug of choice is trastuzumab emtansine. Most patients eventually develop resistance to systemic therapy. Trastuzumab deruxtecan, a novel HER2-targeted antibody drug conjugate, has shown to be promising in this subset. It is a HER2-targeted antibody drug conjugate structurally composed of humanized anti-HER2 monoclonal antibody, cleavable tetra-peptide-based liker, and a potent payload (topoisomerase 1 inhibitor: Exatecan). A phase 2 trial of heavily pretreated advanced HER2-positive breast cancer (median of six lines of prior therapy) showed an overall response of 61% and a median progression-free survival of 16 months. In December 2019, the Food and Drug Administration announced accelerated approval of trastuzumab deruxtecan for HER2-positive advanced breast cancer patients who were prior exposed to two or more lines of anti-HER2 therapy in a metastatic setting.


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