This single-center retrospective study evaluated real-world efficacy of datopotamab deruxtecan (Dato-DXd) in 45 heavily pretreated patients with HR+/HER2− metastatic breast cancer (median 6 prior lines), comparing outcomes in 19 patients with prior T-DXd exposure vs. 26 T-DXd-naïve patients.
Overall DCR was 57.8% and ORR 24.4%; in the prior T-DXd group, DCR was 52.6% and ORR 10.5%, with median TTF 3.4 months and median PFS 3.0 months. In T-DXd-naïve patients, DCR was 61.5%, ORR 34.6%, and median PFS 5.1 months. Among 16 patients with evaluable prior T-DXd TTF data, 5 (31.3%) had a longer TTF with Dato-DXd than with prior T-DXd.
- Small single-center cohort (n=45) limits generalizability and statistical power; wide CIs reflect substantial uncertainty. - Prior T-DXd group was more heavily pretreated (2 additional chemotherapy lines), making unadjusted between-group comparisons prone to confounding. - No comparator arm; relative efficacy of Dato-DXd vs. other post-T-DXd options is unknown.
Dato-DXd can yield disease control in over half of patients previously treated with T-DXd, but response rates and PFS are modest—clinicians should counsel patients on limited but real benefit in this heavily pretreated setting. The ongoing TRADE-DXd trial (NCT06533826) will provide prospective sequencing data.
Explore related topics
