Turn on cookies to sign in
Signing in saves your progress to your Curie account. We can only do that with cookies on — turn them on to continue.
Two major trials — DESTINY-Breast11 and DESTINY-Breast05 — have both shown impressive results for T-DXd (Enhertu) in early-stage HER2-positive breast cancer, but clinicians are now wrestling with how to use both datasets in practice. Dr. Tiffany Traina says the key lies in better biomarkers — from imaging and pathologic response to circulating tumor DNA — to help identify who needs more or less aggressive treatment.
Two landmark phase 3 trials — DESTINY-Breast11 and DESTINY-Breast05 — have put T-DXd (fam-trastuzumab deruxtecan; Enhertu) front and center in early-stage HER2-positive breast cancer. DESTINY-Breast11 showed dramatic pathologic complete response rates with T-DXd followed by a taxane-based regimen in the neoadjuvant setting, while DESTINY-Breast05 demonstrated strong adjuvant outcomes for high-risk patients with residual disease after neoadjuvant therapy. The catch? Both trials ran simultaneously, and now clinicians are left figuring out how to integrate two powerful — and potentially overlapping — treatment strategies.
Speaking at the 2026 Bridging the Gaps in Breast Cancer Meeting, Dr. Tiffany Traina of Memorial Sloan Kettering Cancer Center highlighted that the central challenge is patient selection: who needs treatment escalation, and who might safely de-escalate? Traditional markers like imaging response and pathologic complete response remain valuable, but the field is increasingly looking toward molecular, tissue-based, and dynamic biomarkers like circulating tumor DNA (ctDNA).
Key Takeaways:
Why it matters: With two strong T-DXd datasets now available, oncologists face real-world complexity in sequencing and selecting therapies. Developing robust biomarker tools will be critical to personalizing care and avoiding over- or under-treatment in early HER2-positive breast cancer.
