Gregory Vidal, MD, PhD

Panelists discussed the persistent risk of interstitial lung disease with trastuzumab deruxtecan, emphasizing the need for early detection through routine imaging, rapid intervention to prevent severe toxicity, and cautious retreatment in select cases where interstitial lung disease was mild and well managed.

Panelists discussed how DESTINY-Breast03 firmly established trastuzumab deruxtecan (T-DXd) as the second-line standard in HER2-positive metastatic breast cancer, while early DESTINY-Breast09 data suggest that T-DXd combined with pertuzumab may challenge the CLEOPATRA regimen in the frontline setting, though questions remain about global applicability.

Panelists discussed how maintenance therapy in HER2-positive metastatic breast cancer is evolving beyond traditional dual antibody approaches, with emerging strategies incorporating targeted agents like tucatinib and endocrine therapy to personalize care and potentially delay central nervous system progression.

Panelists discussed how evolving strategies in HER2-positive metastatic breast cancer are shifting toward more personalized maintenance approaches, including the integration of CDK4/6 inhibitors and endocrine therapy, with growing interest in chemotherapy-free options for select patients.

A commentary on key takeaways from TROPiCS-02, remaining questions and unmet needs in the field, and the clinical implications of using SG and other Trop-2–directed ADCs in patients with HR+/HER2- mBC.

Drs Dietrich, Tolaney, and Vidal comment on PFS subgroup analyses, response rates, and common adverse events (AEs) observed in the TROPiCS-02 trial.

Experts discuss progression-free survival (PFS) and overall survival (OS) data from the TROPiCS-02 trial on SG versus treatment of physician’s choice.

Dr Tolaney discusses the TROPiCS-02 study design and comments on the key baseline characteristics of the patients with HR+/HER2- mBC who were enrolled in the trial.

Dr Vidal elaborates on the role of trophoblast cell-surface antigen 2 (Trop-2) in metastatic breast cancer and discusses the rationale for using Trop-2–directed antibody-drug conjugates (ADCs), including sacituzumab govitecan (SG), in patients with the disease.

Sara Tolaney, MD, MPH introduces the 2022 Journal of Clinical Oncology preprint publication, “Sacituzumab Govitecan in Hormone Receptor–Positive/ Human Epidermal Growth Factor Receptor 2–Negative Metastatic Breast Cancer” and invites Martin Dietrich, MD, PhD and Gregory Vidal, MD, PhD to comment on the typical patients with hormone receptor–positive (HR+)/human epidermal growth factor receptor 2–negative (HER2-) metastatic breast cancer (mBC) who they see in their clinical practice.