Where should T-DXd fit in the treatment of high-risk, early-stage HER2-positive breast cancer?

At This Moment in Medicine, hosted by Community Health Media, Dr. Michelina Cairo reviews the latest data from DESTINY-Breast11 and DESTINY-Breast05, examining how trastuzumab deruxtecan (T-DXd) could reshape treatment in both the neoadjuvant and adjuvant settings.

From pathologic complete response and invasive disease-free survival to ILD risk and treatment sequencing, the presentation explores how clinicians might balance efficacy, toxicity, and individual recurrence risk as T-DXd moves into earlier-stage disease.

Topics discussed:

• Current treatment for high-risk HER2-positive early breast cancer
• DESTINY-Breast11 and neoadjuvant T-DXd followed by THP
• Pathologic complete response and residual cancer burden
• DESTINY-Breast05 and T-DXd versus T-DM1
• Invasive disease-free survival and emerging CNS outcomes
• ILD, nausea, cardiac safety, and treatment duration
• Neoadjuvant versus adjuvant use of T-DXd
• Whether THP alone may be sufficient for selected patients
• The potential role of ctDNA
• Where T-DM1 may still fit for residual disease
• Individualizing treatment according to recurrence risk

The presentation concludes with a panel discussion exploring one of the biggest unanswered questions: How much T-DXd is enough—and when should it be used?

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#ThisMomentInMedicine #MichelinaCairo #BreastCancer #HER2Positive #TDXd #TrastuzumabDeruxtecan #DESTINYBreast11 #DESTINYBreast05 #BreastOncology #MedicalOncology #CommunityHealthMedia

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