Key updates on the use of Trastuzumab Deruxtecan in the treatment of breast cancer

Abstract

Objective: To carry out a narrative review of updates on the use of the new drug Trastuzumab Deruxtecan (T-Dxd) as a therapy for breast cancer, including its mode of action, comparison with other drugs, adverse effects and availability. Bibliographic review: The studies indicate that T-Dxd is a promising treatment that has action directed at the human epidermal growth factor receptor type 2 (HER-2), having a cytotoxic effect of limited scope to the tumor microenvironment and minimized systemic exposure. The action on brain metastases, significant antitumor activity in patients with extensively pre-treated HER2-positive metastatic breast cancer and efficient activity in patients with HER2-low breast cancer were proven. In other cancers, the increase in survival compared to conventional therapies such as in the case of gastric cancer was analyzed. Its adverse effects are predominantly observed in the gastrointestinal and hematological system, but interstitial lung disease is a possible effect to be monitored. Final considerations: The results show that T-Dxd is a promising drug with several benefits, with limited use, since there is a need for more scientific studies about its effects and greater depth of the real benefit that its use, as a therapy of first line, would bring to HER2-positive patients.