Evidence map›Paper›PMID 39754978›Full record

ArticleESMO open2025

Results of a patient-level pooled analysis of three studies of trastuzumab deruxtecan in HER2-positive breast cancer with active brain metastasis.

R Bartsch, J M Pérez-García, J Furtner, A S Berghoff, M Marhold, A M Starzer, M Hughes, S Kabraji, S Sammons, C Anders and 12 more

Abstract read
In one paragraph

Article in ESMO open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed.

  1. Trial
  2. Review
  3. Review
  4. Article
  5. Article
  6. Review
  7. Article
  8. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

22 authors.

R BartschDepartment of Medicine I, Division of Oncology, Medical University of Vienna, Vienna, Austria.
J M Pérez-GarcíaMedica Scientia Innovation Research (MEDSIR), Barcelona, Spain; International Breast Cancer Center, Pangea Oncology, QuironSalud Group, Barcelona, Spain.
J FurtnerDepartment of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna; Research Center for Medical Image Analysis and Artificial Intelligence (MIAAI), Faculty of Medicine and Dentistry, Danube Private University, Krems, Austria.
A S BerghoffDepartment of Medicine I, Division of Oncology, Medical University of Vienna, Vienna, Austria.
M MarholdDepartment of Medicine I, Division of Oncology, Medical University of Vienna, Vienna, Austria.
A M StarzerDepartment of Medicine I, Division of Oncology, Medical University of Vienna, Vienna, Austria.
M HughesDana-Farber Cancer Institute, Boston.
S KabrajiRoswell Park Comprehensive Cancer Center, Buffalo.
S SammonsDana-Farber Cancer Institute, Boston.
C AndersDuke Cancer Institute, Durham.
R K MurthyMD Anderson Cancer Center, Houston, USA.
A E D Van SwearingenDuke Cancer Institute, Durham.
A PeresleteDana-Farber Cancer Institute, Boston.
M GionIOB Madrid, Hospital Beata María Ana, Madrid, Spain.
M Vaz BatistaMedica Scientia Innovation Research (MEDSIR), Barcelona, Spain; Hospital Professor Doutor Fernando Fonseca EPE, Lisbon, Portugal.
S BragaHospital Professor Doutor Fernando Fonseca EPE, Lisbon, Portugal.
P B C PintoMedica Scientia Innovation Research (MEDSIR), Barcelona, Spain.
M Sampayo-CorderoMedica Scientia Innovation Research (MEDSIR), Barcelona, Spain.
A Llombart-CussacMedica Scientia Innovation Research (MEDSIR), Barcelona, Spain; Hospital Arnau de Vilanova, Universidad Católica de Valencia, Valencia.
M PreusserDepartment of Medicine I, Division of Oncology, Medical University of Vienna, Vienna, Austria.
J CortésMedica Scientia Innovation Research (MEDSIR), Barcelona, Spain; International Breast Cancer Center, Pangea Oncology, QuironSalud Group, Barcelona, Spain; IOB Madrid, Hospital Beata María Ana, Madrid, Spain; Department of Medicine, Faculty of Biomedical and Health Sciences, Universidad Europea de Madrid, Madrid, Spain. Electronic address: javier.cortes@maj3.health.
N U LinDana-Farber Cancer Institute, Boston. Electronic address: nancy_lin@dfci.harvard.edu.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundBrain metastases (BMs) are common in human epidermal growth factor receptor 2 (HER2)-positive advanced breast cancer, increasing morbidity and mortality. Systemic therapy for BMs can be effective, with the triple combination of trastuzumab, capecitabine, and tucatinib being a potential standard. More recently, intracranial activity of antibody-drug conjugates has been reported, but the size of individual studies has been small. Therefore, this patient-level pooled analysis was conducted. PATIENTS AND

methodsThis is a patient-level pooled analysis of the prospective phase II DEBBRAH and TUXEDO-1 trials and the retrospective DFCI/Duke/MDACC cohort. Patients with evaluable active BMs (defined as newly diagnosed and untreated or progressing with measurable tumor-related size after previous local therapy) from HER2-positive breast cancer (BC) and treated with trastuzumab deruxtecan (T-DXd) included in these studies were eligible. The primary endpoint was intracranial objective response rate (ORR-IC) by Response Assessment in Neuro-Oncology (RANO)-BM criteria.

resultsOverall, 37 patients were assessable for intracranial response assessment. BMs progressing after prior local therapy were present in 64.9% of patients. The median patient age was 49.1 years. All patients had received prior trastuzumab and the median number of prior systemic treatment lines was 3 (0-13). The pooled ORR-IC by RANO-BM criteria was 64.9% [95% confidence interval (CI) 47.5% to 79.8%] with low heterogeneity observed between the studies included. The clinical benefit rate by RANO-BM was 81.1% (95% CI 64.8% to 92.0%). The median progression-free survival was 13.3 months (95% CI 8.4-22.6 months) and the median overall survival was 22.5 months (95% CI 14.9 months-not achieved) with high heterogeneity between studies and numerically longer in patients with few prior treatment lines. Quality of life remained stable throughout treatment, with no new safety concerns.

conclusionsThis patient-level pooled analysis of DEBBRAH, TUXEDO-1, and the DFCI/Duke/MDACC cohort indicates clinically relevant intracranial activity of T-DXd in patients with active HER2-positive BC, BMs, and extensive systemic pretreatment. The results therefore support the use of T-DXd when clinically indicated irrespective of BMs.

Indexed as

Antineoplastic Agents, ImmunologicalBrain NeoplasmsBreast NeoplasmsErb-b2 Receptor Tyrosine KinasesImmunoconjugatesTrastuzumabAdultAgedCamptothecinFemaleHumansMiddle AgedProspective StudiesRetrospective StudiesAntineoplastic Agents, ImmunologicalCamptothecinERBB2 protein, humanErb-b2 Receptor Tyrosine KinasesImmunoconjugatesTrastuzumabtrastuzumab deruxtecanactive brain metastasesHER2-positive breast cancersystemic therapytrastuzumab deruxtecan

Identifiers

PMID39754978
PMCPMC11758132

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.