First-line breast cancer is in Enhertu’s Destiny

AstraZeneca and Daiichi’s HER2-targeting ADC Enhertu has sold well with a second-line label, but the partners are looking at earlier-stage cancers – and now they have the first positive signs. On Monday the groups toplined a win in the Destiny-Breast09 trial in first-line HER2-positive breast cancer following an interim analysis. The partners would only say that Enhertu plus Roche’s Perjeta produced a “highly statistically significant and clinically meaningful improvement” on the primary endpoint of progression-free survival, versus Perjeta plus Herceptin plus chemo. A benefit was seen across all prespecified subgroups, suggesting activity at the low end of the HER2-positive spectrum; full results will be presented at an upcoming medical meeting. Overall survival was immature, although there was a trend favouring Enhertu plus Perjeta, the companies said. The trial is also testing Enhertu monotherapy versus the triplet control; there was no word on this arm, which will continue to final analysis. Beyond the front line, Astra and Daiichi have their eye on even earlier breast cancer settings, with the adjuvant Destiny-Breast05 and neoadjuvant Destiny-Breast11 set to read out this year. And other tumours are also on the agenda, with first-line trials in lung, gastric and ovarian cancers.

Pivotal trials of Enhertu in early-stage cancers

Source: OncologyPipeline & clinicaltrials.gov.