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4

Indication details

Control Arm
Pysician's ChT choice (eribulin, capecitabine, gemcitabine, nab-paclitaxel, or paclitaxel)
Therapeutic Indication
Treatment of patients with unresectable or metastatic HER2‑low breast cancer who have received prior chemotherapy in the metastatic setting or developed disease recurrence during or within 6 months of completing adjuvant chemotherapy
Tumour Sub-type
Breast Cancer
Tumour Stage
Unresectable or metastatic
Tumour Sub-Group
HER2-low
Trial Name
DESTINY-Breast04
NCT Number
NCT03734029
Trial Phase
Phase III

Approval details

FDA Approval
FDA approval August 2022
EMA Approval
EMA (CHMP) December 2022 EC decision February 2023

Primary Outcome(s)

Primary Outcome(s)
PFS and OS hierarchically tested
Evaluated Outcome
OS (all patients)
Form(s)
Form 2a

Outcome Data

PFS Control
5.1 months
PFS Gain
4.8 months
PFS HR
0.50 (0.40–0.63)
OS Control
16.8 months
OS Gain
6.6 months
OS HR
0.64 (0.49–0.84)

Adjustments

QoL Comment
QoL was not a prespecified endpoint

Score (after adjustments)

Preliminary non-curative score

4

Non-curative score

4

Scorecard details

ESMO-MCBS version
ESMO-MCBS v1.1
Scorecard ID
351
Scorecard version
1
Issue date
22.09.2022
Last update
20.12.2022
Trastuzumab deruxtecan DESTINY-Breast04

PRELIMINARY SCORE

OS

ADJUSTMENTS

Trastuzumab deruxtecan DESTINY-Breast04

SCORE

Overall Survival / Disease-Free Survival / Pathological Complete Response
4
Overall Survival
Progression-Free Survival
Non-inferiority (Improved Quality of Life or Reduced Adverse Events) / Response Rate
Overall Response Rate / Duration of Response
Treatment of patients with unresectable or metastatic HER2‑low breast cancer who have received prior chemotherapy in the metastatic setting or developed disease recurrence during or within 6 months of completing adjuvant chemotherapy
Trastuzumab deruxtecan
Pysician's ChT choice (eribulin, capecitabine, gemcitabine, nab-paclitaxel, or paclitaxel)

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    Legend

    Information about symbols, abbrevations and color codes

    Red = negative
    Green = positive
    Grey = neutral
    ? Grey + ? = neutral with pending data
    DFS
    Disease-Free Survival
    DoR
    Duration of Response
    EFS
    Event-Free Survival
    HR
    Hazard Ratio
    NEB
    No evaluable benefit
    NI
    Non-inferiority Study
    ORR
    Overall Response Rate
    OS
    Overall Surival
    pCR
    Pathological Complete Response/Remission
    PFS
    Progression-Free Survival
    QoL
    Quality of Life
    RFS
    Relapse-Free Survival
    RR
    Response Rate

    QoL adjustments

    Other adjustments*

    Serious and disabling adverse effects

    Red = negative / deterioration

    Green = positive / improvement

    QoL adjustments

    Red = negative / deterioration

    Green = positive / improvement

    Other adjustments*

    Red = negative / deterioration

    Green = positive / improvement

    Serious and disabling adverse effects

    Red = negative / deterioration

    Green = positive / improvement

    * Other adjustments include:

    - Long-term plateau in the survival curve
    - Long-term plateau in the PFS curve
    - Early stopping or crossover
    - Only improved PFS mature data shows no OS advantage and no improved Qol.

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