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Sara Hurvitz is a breast cancer trialist who led DESTINY-Breast03, the trial where Enhertu beat Kadcyla.
Sara Hurvitz is Senior Vice President and Director of the Clinical Research Division at Fred Hutchinson Cancer Center and Head of the Division of Hematology and Oncology at the University of Washington, having moved from UCLA in 2023. A breast medical oncologist specialising in HER2 and antibody-drug conjugates, she was principal investigator of DESTINY-Breast03, the trial in which trastuzumab deruxtecan was compared with trastuzumab emtansine, and of many HER2-directed and CDK4/6 studies. Her papers report the updated results of DESTINY-Breast03 in the Lancet and the KRISTINE phase 3 trial of neoadjuvant trastuzumab, pertuzumab and chemotherapy versus trastuzumab emtansine plus pertuzumab in Lancet Oncology. Her work spans HER2-positive, HR-positive and triple-negative breast cancer.
Ribociclib is a second adjuvant CDK4/6 option, and the only one with data in node-negative stage II disease. Roughly 3 in 100 patients avoid a relapse or death at three years, so the decision depends heavily on individual risk, tolerance of a three-year oral drug, and cost. Whether the benefit persists after treatment ends, as it did with abemaciclib, needs longer follow-up.
For HER2-positive metastatic breast cancer that has progressed after trastuzumab and a taxane, trastuzumab deruxtecan is now the standard second-line treatment and T-DM1 has moved later in the sequence. The benefit is large enough that ADC design, not just the target, is understood to be what matters. Patients need lung monitoring because of the risk of pneumonitis.
Sacituzumab govitecan is a standard second-line or later treatment for metastatic triple-negative breast cancer, roughly doubling survival compared with the chemotherapies it was tested against. Patients should expect neutropenia and diarrhoea, which are manageable with growth factor support and loperamide. Trials are now testing it earlier, in first-line combinations with pembrolizumab and after surgery for residual disease.
Shares DESTINY-Breast03, DESTINY-Breast03: trastuzumab deruxtecan beats T-DM1 as second-line treatment of HER2-positive metastatic breast cancer, Trastuzumab emtansine, Trastuzumab deruxtecan.
Shares DESTINY-Breast03, DESTINY-Breast03: trastuzumab deruxtecan beats T-DM1 as second-line treatment of HER2-positive metastatic breast cancer, Trastuzumab emtansine, Trastuzumab deruxtecan.
Shares DESTINY-Breast03, DESTINY-Breast03: trastuzumab deruxtecan beats T-DM1 as second-line treatment of HER2-positive metastatic breast cancer, ASCENT: sacituzumab govitecan doubles survival in heavily pretreated metastatic triple-negative breast cancer, Trastuzumab emtansine.
Shares Trastuzumab deruxtecan, HER2, HER2-positive breast cancer, Antibody-drug conjugate (ADC).
Shares DESTINY-Breast03: trastuzumab deruxtecan beats T-DM1 as second-line treatment of HER2-positive metastatic breast cancer, Trastuzumab deruxtecan, HER2, HER2-positive breast cancer.
Shares NATALEE: three years of ribociclib after surgery in a broad population of hormone-receptor-positive early breast cancer, DESTINY-Breast03: trastuzumab deruxtecan beats T-DM1 as second-line treatment of HER2-positive metastatic breast cancer, HER2, HER2-positive breast cancer.
Shares Trastuzumab deruxtecan, HER2-positive breast cancer, Antibody-drug conjugate (ADC), HR-positive / HER2-negative breast cancer.
Shares Trastuzumab emtansine, HER2-positive breast cancer, Antibody-drug conjugate (ADC).