In today’s episode, we spoke with Paolo Tarantino, MD, PhD. Dr Tarantino is a breast medical oncologist and advanced fellow at Dana-Farber Cancer Institute and Harvard Medical School in Boston, Massachusetts.<br>In our exclusive interview, Dr Tarantino discussed practice-informing data regarding antibody-drug conjugates in breast cancer that were presented at the 2026 ASCO Annual Meeting, including the use of fam-trastuzumab deruxtecan-nxki (T-DXd; Enhertu) plus pertuzumab (Perjeta) for first-line treatment of HER2-positive breast cancer based on findings from the phase 3 DESTINY-Breast09 trial (NCT04784715); updated safety data from the phase 3 DESTINY-Breast05 trial (NCT04622319) that indicated that T-DXd–associated interstitial lung disease is reversible with steroids, although radiation pneumonitis is non-reversible; and the phase 3 OPTIMA trial (ISRCTN42400492) results, which suggested that the PAM50 signature can identify patients who may not need chemotherapy, potentially sparing them from unnecessary treatment.

ASCO 2026 ADC Data Clarify Some Strategies and Raise Further Questions for Breast Cancer Care: With Paolo Tarantino, MD, PhD

OncLive® On Air

Thank you so much for taking the time to speak with us on an episode of OncLive On Air discussing some breast cancer updates with ADCs from ASCO 2026. So just to start with a bit of background here, TDXD plus pertuzumab was recently FDA approved based on findings from Destiny Breast Zone 9. So can you really discuss some of the key findings from the primary analysis of that study that supported this approval?

Absolutely. I think it's been kind of a little big revolution because for about 10 years we've been doing the same for the first line treatment over to positive breast cancer that was induction toxin with HP followed by HP maintenance. And now suddenly that has been displaced by TDXD pertuzumab based on DB09.

This was a trial that had three different arms looking at either first line TDXD pertuzumab or TDXD alone versus THP for the first line treatment over to positive breast cancer. The trial was positive at positive PFS with a very long PFS for TDXD pertuzumab of about 40 months compared to approximately 26 months with THP. We still don't know with TDXD alone. We're waiting for the results of that arm.

And overall, I believe that the strategy of giving TDXD pertuzumab allows to go beyond the traditional four to five months of induction chemo that we did with taxanes, which is, of course, an opportunity because TDXD does not come with cumulative peripheral neuropathy. But at the same time, it adds burden of chemo related side effects for patients.

And so right now we consider that TDXD pertuzumab is the preferred first line treatment approach, but we are still trying to determine what is the adequate duration of TDXD pertuzumab.

ASCO 2026 ADC Data Clarify Some Strategies and Raise Further Questions for Breast Cancer Care: With Paolo Tarantino, MD, PhD

Read the full transcript

The candid version is on a podcast,
not the earnings call.

ASCO 2026 ADC Data Clarify Some Strategies and Raise Further Questions for Breast Cancer Care: With Paolo Tarantino, MD, PhD

Read the full transcript

The candid version is on a podcast, not the earnings call.

The candid version is on a podcast,
not the earnings call.