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Reading the faint end of the HER2 stain decides who gets Enhertu.
This diagnostic-therapeutic pairing links Histopathology & immunohistochemistry scoring of HER2 to treatment with Trastuzumab deruxtecan (T-DXd): reading the faint end of the HER2 stain decides who gets Enhertu. The rationale is that the bystander payload needs only minimal antigen for uptake, so the immunohistochemistry cut-off is a delivery threshold rather than a driver threshold. In the phase 3 DESTINY-Breast04 and DESTINY-Breast06 trials, HER2-low (IHC 1+ or 2+) and HER2-ultralow (IHC 0 with faint staining) tumours predicted T-DXd benefit in HR-positive / HER2-negative breast cancer and Triple-negative breast cancer (TNBC). Reproducibility at the low end is poor, so AI-assisted HER2 scoring is being validated, as pursued in the idea AI quantification of HER2-low and HER2-ultralow.
Shares DESTINY-Breast06, AI quantification of HER2-low and HER2-ultralow, DESTINY-Breast04, HER2-low and HER2-ultralow.
Shares DESTINY-Breast04, Trastuzumab deruxtecan, Triple-negative breast cancer (TNBC), HR-positive / HER2-negative breast cancer.
Shares DESTINY-Breast06, HER2-low and HER2-ultralow, Trastuzumab deruxtecan.
Shares AI quantification of HER2-low and HER2-ultralow, Trastuzumab deruxtecan, HR-positive / HER2-negative breast cancer.
Shares DESTINY-Breast04, HER2-low and HER2-ultralow, Trastuzumab deruxtecan, Triple-negative breast cancer (TNBC).
Shares DESTINY-Breast04, HER2-low and HER2-ultralow, Trastuzumab deruxtecan, Triple-negative breast cancer (TNBC).
Shares HER2-low and HER2-ultralow, Histopathology & immunohistochemistry, HR-positive / HER2-negative breast cancer.
Shares DESTINY-Breast06, HER2-low and HER2-ultralow, Trastuzumab deruxtecan, Triple-negative breast cancer (TNBC).