The FDA approved datopotamab deruxtecan (Datroway) for adults with unresectable or metastatic, hormone receptor (HR)-positive, HER2-negative breast cancer. Patients must have received prior endocrine-based therapy and chemotherapy. The approval is based on the TROPION-Breast01 trial, which showed improved progression-free survival (PFS) compared to chemotherapy.

Key Insights

• Efficacy: The TROPION-Breast01 trial showed datopotamab deruxtecan significantly improved PFS. The median PFS was 6.9 months versus 4.9 months for chemotherapy (Hazard ratio 0.63, p < 0.0001).
• Safety: Common side effects included stomatitis, nausea, fatigue, and laboratory abnormalities like decreased leukocytes and hemoglobin.
• Patient Population: The drug is for patients with disease progression who cannot continue endocrine therapy. Eligible patients must have received one or two prior lines of chemotherapy for unresectable or metastatic disease.
• Dosage: The recommended dose is 6 mg/kg (maximum 540 mg for patients ≥90 kg), given as an intravenous infusion every three weeks.

Background Context

• Breast Cancer Subtypes: HR-positive, HER2-negative breast cancer is common. Treatments like datopotamab deruxtecan target specific molecular features. The FDA’s approval aligns with ongoing efforts to develop more targeted therapies.
• Clinical Trials: The TROPION-Breast01 trial was a multicenter, open-label, randomized study. This design is crucial for evaluating cancer treatments and is often referenced by organizations like the FDA and the National Cancer Institute (NCI).

Implications

• Health Economics: The approval could impact healthcare costs and resource allocation. Targeted therapies can be expensive but may reduce long-term costs by improving outcomes and lowering the need for additional treatments.
• Health Outcomes: Better PFS and overall survival can enhance patients’ quality of life. This approval may also encourage further research into targeted cancer therapies.
• Clinical Practice: Datopotamab deruxtecan introduces a new option for treating HR-positive, HER2-negative breast cancer. It offers healthcare providers another choice for patients who have exhausted other treatments, potentially improving personalized treatment strategies.

This approval highlights the role of innovative treatments in improving patient outcomes and potentially reducing healthcare costs. Ongoing research and clinical trials remain crucial for developing and evaluating new therapies.