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Dec 22, 2021 โ€ข 24 tweets โ€ข 16 min read โ€ข Read on X
1/ ๐ŸŒŸ Calling #Oncology HCPs ๐ŸŒŸ

๐Ÿ†• #TumorBoardTuesday #Tweetorial
๐Ÿšจ ๐Ÿงฌ HER2 in Breast Cancer
๐Ÿ‘ฅ @MPishvaian & @ErikaHamilton9

Supported by educational grants from AstraZeneca Pharmaceuticals & Daiichi Sankyo, Inc.

CME โ„น๏ธ bit.ly/3ecVOcC

๐Ÿ—ฃ๏ธ What's your specialty โ‰๏ธ
2/ ๐Ÿ—’๏ธ Full reference list & glossary ๐Ÿ‘‰ bit.ly/3yMvIGW

๐Ÿ”‘ Key #CME & faculty info ๐Ÿ‘‡, full info ๐Ÿ‘‰ bit.ly/3ecVOcC

#TumorBoardTuesday
3/ ๐Ÿ›‘ POLL ๐Ÿ›‘

๐Ÿค” In a Ph3 trial, which agent has demonstrated an ORR of nearly 80% โ“
#TumorBoardTuesday
4/ T-DXd = correct! #TumorBoardTuesday

โญ๏ธ Preferred 2L Tx ๐Ÿ’Š for ๐Ÿงฌ HER2โž• ๐Ÿ” unresectable BC/mBC

๐Ÿ“Œ DESTINY-Breast03, open-label, Ph3 trial
๐Ÿ‘‰ 2L T-DXd ๐Ÿ†š T-DM1 in prev-Tx, HER2โž• mBC

โฌ†๏ธ PFS
โœ–๏ธ OS not significant, trend encouraging
๐Ÿ—’๏ธ Early data; TEAE rate similar
โฌ†๏ธ ILD
5/ T-DM1 now 2L โ€˜other recommended regimenโ€™ ๐Ÿ‘
for patients w/ ๐Ÿงฌ HER2โž• ๐Ÿ” unresectable or mBC

๐Ÿฉบ Survival benefits meaningful but modest
โœ… Improvement ๐Ÿ†š lapatinib/capecitabine
๐Ÿ‘‰ mPFS: 3.2mo
๐Ÿ‘‰ mOS: 5.8mo

๐Ÿšซ No SOC for progression after Tx ๐Ÿ’Š w/ T-DM1
#TumorBoardTuesday
6/ ๐Ÿ›‘ POLL ๐Ÿ›‘

๐Ÿค” In a Ph2 trial, which agent has demonstrated a PFS at 1 year of nearly 25% in ๐Ÿง‘ patients w/ ๐Ÿง  brain mets โ“
#TumorBoardTuesday
7/ Tucatinib = correct! #TumorBoardTuesday

โœ… FDA-approved 2L Tx ๐Ÿ’Š
๐Ÿง‘ Patients w/ ๐Ÿงฌ HER2โž• advanced unresectable or mBC

๐Ÿ“Œ HER2CLIMB: Ph2 trial ๐Ÿ†š placebo in prev-Tx patients
โฌ†๏ธ PFS & OS ยฑ ๐Ÿง  mets
๐Ÿ“‘ NCCN 3L โ€˜other recommended'; 2L โ€˜preferredโ€™ for patients w/ ๐Ÿง  mets
8/ โ€ผ๏ธ Recently โœ… approved agents for 3L Tx ๐Ÿ’Š for ๐Ÿง‘ Patients w/ ๐Ÿงฌ HER2โž• ๐Ÿ” unresectable or mBC

๐Ÿ‘‰ T-DXd
๐Ÿ‘‰ Margetuximab

#TumorBoardTuesday
9/ ๐Ÿ›‘ POLL ๐Ÿ›‘

๐Ÿค” Among AEs of special interest, which was the most common w/ T-DXd Tx ๐Ÿ’Š โ“
#TumorBoardTuesday
10/ ILD = correct! #TumorBoardTuesday

๐Ÿ“Œ DESTINY-Breast01
๐Ÿงช Single-arm, Ph2 trial of T-DXd
๐Ÿง‘ Patients w/ ๐Ÿงฌ HER2โž• mBC previously Tx ๐Ÿ’Š w/ T-DM1

โญ๏ธ Durable antitumor activity โ€ผ๏ธ
๐Ÿซ Incidence of ILD warrants attention to & monitoring of pulmonary symptoms
11/ ๐Ÿ‘‰ Next: DESTINY-Breast02

๐Ÿ—’๏ธ Open-label, randomized, Ph3 trial
๐Ÿ”Ž T-DXd ๐Ÿ†š standard Tx ๐Ÿ’Š
๐Ÿง‘ Patients w/ ๐Ÿงฌ HER2โž• unresectable &/or mBC previously Tx ๐Ÿ’Š w/ T-DM1

โœ… Trial to confirm results of Ph2 DESTINY-Breast01 & support FDA approval
#TumoBoardTuesday
12/ #TumorBoardTuesday ๐Ÿ“Œ SOPHIA

๐Ÿ”Ž Ph3 trial of margetuximab โž• chemo ๐Ÿ†š trastuzumab โž• chemo
๐Ÿง‘ Patients w/ aBC
๐Ÿ’Š Previously Tx w/ 2 or more anti-HER2 Tx & 1-3 prior Tx for mBC

โœ… PFS statistically significantly improved
โœ–๏ธ OS not significant
๐Ÿ‘ Acceptable safety profile
13/ โ€ผ๏ธ Experimental Tx ๐Ÿงช ๐Ÿ’Š #TumorBoardTuesday

๐Ÿ“Œ Recently approved agents undergoing further evaluation ๐Ÿ“Š

๐Ÿ‘‰ T-DXd
๐Ÿ‘‰ Tucatinib (recruiting)
๐Ÿ‘‰ Novel agent ๐ŸŒŸ T-duocarmazine ๐ŸŒŸ
14/ โ€ผ๏ธ HER2CLIMB-02

๐Ÿ“Š Randomized, double-blind, Ph3 trial
๐Ÿ’Š T-DM1 โž•/โž– tucatinib
๐Ÿง‘ Patients w/ unresectable locally โฌ†๏ธ a/mBC

๐Ÿฅ… Goal: determine utility of tucatinib in earlier lines of Tx ๐Ÿ’Š

๐Ÿ“Œ Status: recruiting
#TumorBoardTuesday
15/ โ€ผ๏ธ HER2CLIMB-04

๐Ÿ”Ž Single-arm, Ph2 trial
๐Ÿง Tucatinib โž• T-DXd
๐Ÿง‘ Patients w/ unresectable, locally-advanced or metastatic ๐Ÿงฌ HER2โž• BC

๐Ÿฅ… Goal: determine efficacy & ๐Ÿฆบ safety of tucatinib โž• T-DXd

๐Ÿ“Œ Status: recruiting
#TumorBoardTuesday
16/ ๐Ÿงญ CompassHER2 RD

๐Ÿง Randomized, double-blind, Ph3 trial
๐Ÿ”Ž T-DM1 โž•/โž– tucatinib
๐Ÿง‘ Patients w/ โฌ†๏ธ high-risk, ๐Ÿงฌ HER2โž• BC

๐Ÿฅ… Goal: determine superiority of tucatinib โž• T-DM1 to T-DM1 alone

๐Ÿ“Œ Status: recruiting
#TumorBoardTuesday
17/ ๐ŸŒท TULIP

๐Ÿ—’๏ธ Open-label, randomized, Ph3 trial
๐Ÿงช T-duocarmazine ๐Ÿ†š physicianโ€™s choice i
๐Ÿง‘ Patients w/ ๐ŸงฌHER2โž• unresectable locally a/mBC

๐Ÿฅ… Purpose: demonstrate superiority of T-duocarmazine to physicianโ€™s choice in prolonging PFS
#TumorBoardTuesday
18/ ๐Ÿ”‘๐Ÿ”‘๐Ÿ”‘ Key points โ€ผ๏ธ #TumorBoardTuesday

๐Ÿ“Œ T-DXd emerged as current SOC in 2L

๐Ÿ“Œ Multiple other approved Tx ๐Ÿ’Š
๐Ÿ‘‰Tucatinib combo
๐Ÿ‘‰T-DM1

๐Ÿ“Œ Clinical trials are ongoing to evaluate ๐Ÿ”
โญ๏ธ T-DXd & tucatinib in earlier lines
โญ๏ธ T-DXd as adjuvant therapy
โญ๏ธ Novel ADCs
19/ Thank you ๐Ÿ™โ€ฏfor joining this ๐Ÿงฌ HER2 in BC #TumorBoardTuesday #Tweetorial!โ€ฏ
โ€ฏ
๐Ÿ‘‰ Knowledge on the go - ๐Ÿ†“ resources: integrityce.com/HER2resources

โ€ผ๏ธ Pick up your #CME ๐Ÿ‘‰ by answering 3 quick questions๐Ÿง โ“

๐Ÿ’ฅ Voila ๐Ÿ’ฅ
20/ #Posttest Q 1โƒฃ #CME #TumorBoardTuesday

๐Ÿค” In a Ph3 trial, which agent has demonstrated an ORR of nearly 80% โ“

Claim credit: bit.ly/3mrBl8z
21/ #Posttest Q 2โƒฃ #CME #TumorBoardTuesday

๐Ÿค” In a Ph2 trial, which agent has demonstrated a PFS at 1 year of nearly 25% in ๐Ÿง‘ patients w/ ๐Ÿง  brain mets โ“

Claim credit: bit.ly/3mrBl8z
22/ #Posttest Q 3โƒฃ #CME #TumorBoardTuesday

๐Ÿค” Among AEs of special interest, which was the most common w/ T-DXd Tx โ“

Claim credit: bit.ly/3mrBl8z
23/ ๐Ÿ™โ€ฏfor joining this #TumorBoardTuesday #Tweetorial โ€ผ๏ธ
โ€ฏ
๐Ÿ‘‰ Knowledge on the go - ๐Ÿ†“ resources: integrityce.com/HER2resources

๐Ÿ’ฅ Stay tuned for more from @TumorBoardTues

โžก๏ธ Now weigh in on tonight's #PancChat โ€ผ๏ธ โฌ…๏ธ

@letswinpc @PanCAN @MPishvaian
10b/ Take a ๐Ÿ‘€ at the DESTINY-Breast01 Trial Data ๐Ÿ“Š #TumorBoardTuesday

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๐ŸงWhere you are in your ๐Ÿฉบ journey?

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