Yakup Ergün, Medical Oncologist at Antalya City Hospital, shared an article on X:
”BEGONIA arm 6: durvalumab + T-DXd showed encouraging 1L activity in HR−/HER2-low mTNBC, mostly PD-L1–negative: ORR 62%, mPFS 12.6 mo. But the ORR threshold was not met and ILD/pneumonitis was 20.7%!
Dato-DXd + durvalumab in BEGONIA arms 7/8 looked numerically stronger: ORR 79%, mDoR 17.6 mo, mPFS 14 mo in the all-comer cohort; ORR 82% in the PD-L1-high cohort.
Of course, PD-L1 enrichment in arm 8 (and 7) likely contributed to these outcomes, so this is not definitive cross-arm proof. Still, the overall signal fits the current TNBC direction: TROP2 may be a more consistent ADC target than the fragile HER2-low label?
With ASCENT-03 and TROPION-Breast02, the PD-L1-negative / IO-ineligible 1L TNBC space is increasingly becoming a TROP2 ADC-based field. HER2-low status alone does not change that interpretation (ASCO26).
Of course, these are still phase 1/2 data.”
Title: First-line durvalumab in combination with trastuzumab deruxtecan in women with locally advanced unresectable or metastatic, hormone-receptor-negative, HER2-low breast cancer: multicenter, open-label, phase 1b/2 BEGONIA platform trial
Authors: Peter Schmid, Seock-Ah Im, Zbigniew Nowecki, Piotr J. Wysocki, Jacek Jassem, Kyung Hae Jung, Simon Lord, Jon Armstrong, Ross Stewart, Petra Vuković, Neelima Denduluri, Yeon Hee Park
