Amol Akhade: Can Dual Checkpoint Blockade Plus Trastuzumab Overcome Resistance in HER2+ MBC?
Amol Akhade, Senior Consultant Medical Oncologist and Hemato-Oncologist at Suyog Cancer Clinics and Reliance Hospitals, shared a post on LinkedIn:
“Can dual checkpoint blockade plus trastuzumab overcome resistance in HER2+ MBC?
Fresh insights from the DIAMOND trial suggest: maybe, but not for all.
BCT 1703 (DIAMOND) evaluated:
Tremelimumab (CTLA-4) + Durvalumab (PD-L1) + Trastuzumab in trastuzumab-resistant HER2+ breast cancer PD-L1 unselected | ER-stratified | Heavily pretreated
Key Results:
- Cohort 1 (ER+)
- ORR: 27%
- PD-L1+: ORR 36%
- TIL ≥5%: ORR 63%
- DOR: up to 30 months
Cohort 3 (Single priming dose Treme)
- 12-mo PFS: 27%
- Lower toxicity than full-dose tremelimumab
- Activity seen even without high PD-L1 or TILs
What’s exciting?
Durable responses in biomarker-enriched subsets A single priming dose of CTLA-4 blockade may be enough Potential to reduce toxicity without compromising efficacy
But…
- Small sample size (N~20 per arm)
- No comparator (e.g., PD-1 mono or trastuzumab + durvalumab)
- Most patients were T-DXd naïve—future relevance uncertain
- Biomarker response inconsistent across ER groups
Takeaway
Dual ICI + HER2-targeting could benefit ER+, PD-L1+, TIL-high patients—but biomarker-driven selection and comparator-controlled trials are essential next steps.
Single-dose CTLA-4 priming might become a smarter, safer way to use dual ICI in breast cancer.”
More posts featuring Amol Akhade.
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Challenging the Status Quo in Colorectal Cancer 2024
December 6-8, 2024
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ESMO 2024 Congress
September 13-17, 2024
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ASCO Annual Meeting
May 30 - June 4, 2024
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Yvonne Award 2024
May 31, 2024
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OncoThon 2024, Online
Feb. 15, 2024
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Global Summit on War & Cancer 2023, Online
Dec. 14-16, 2023