Therapy Areas: Respiratory
Enhertu Granted Breakthrough Therapy Designation in US for Patients with HER2-Positive Metastatic Breast Cancer Treated with One or More Prior Anti-HER2-Based Regimens
7 October 2021 - - The Food and Drug Administration has granted Enhertu (fam-trastuzumab deruxtecan-nxki) Breakthrough Therapy Designation in the US for the treatment of adult patients with unresectable or metastatic HER2-positive breast cancer who have received one or more prior anti-HER2-based regimens, UK-based biopharmaceutical company AstraZeneca (NASDAQ: AZN) said.

Enhertu is a HER2-directed antibody drug conjugate jointly developed by AstraZeneca and Daiichi Sankyo company, Ltd. (hereafter, Daiichi Sankyo).

The FDA granted BTD based on data from the DESTINY-Breast03 registrational trial presented during the European Society for Medical Oncology Congress 2021.

This is the second BTD for Enhertu in breast cancer and now brings the total number of BTDs to four for this medicine.

The US FDA's BTD is designed to accelerate the development and regulatory review of potential new medicines that are intended to treat a serious condition and address a significant unmet medical need.

The new medicine needs to have shown encouraging preliminary clinical results that demonstrate substantial improvement on a clinically significant endpoint over available medicines.

Breast cancer remains the most common cancer worldwide, with more than 2m cases diagnosed in 2020, resulting in nearly 685,000 deaths globally.

Approximately one in five cases of breast cancer are considered HER2-positive.2 Despite initial treatment with trastuzumab and a taxane, patients with HER2-positive metastatic breast cancer will often experience disease progression.

More effective options are needed to further delay progression and extend survival.

In DESTINY-Breast03, Enhertu demonstrated a 72% reduction in the risk of disease progression or death compared to T-DM1 (hazard ratio [HR] 0.28; 95% confidence interval [CI] 0.22-0.37; p=7.8x10-22) in patients with HER2-positive unresectable and/or metastatic breast cancer previously treated with trastuzumab and a taxane.

Nearly all patients treated with Enhertu were alive at one year (94.1%) compared to 85.9% of patients treated with T-DM1. Confirmed objective response rate more than doubled in the Enhertu arm versus the T-DM1 arm (79.7% vs. 34.2%).

The safety profile of Enhertu was consistent with previous clinical trials, with no new safety concerns identified and no Grade 4 or 5 treatment-related interstitial lung disease events.

Previous BTDs for Enhertu were in late-line HER2-positive metastatic breast cancer in 2017 and HER2-mutant metastatic non-small cell lung cancer (NSCLC) and HER2-positive metastatic gastric cancer in 2020.

Enhertu is approved for the treatment of adult patients with unresectable or metastatic HER2-positive breast cancer who have received two or more prior anti-HER2-based regimens in the metastatic setting in the US, Japan, the EU and several other countries based on the results from the DESTINY-Breast01 trial.

Enhertu is being further assessed in a comprehensive clinical development program evaluating efficacy and safety across multiple HER2-targetable cancers, including breast, gastric, lung and colorectal cancers.

Daiichi Sankyo and AstraZeneca entered into a global collaboration to jointly develop and commercialize Enhertu (a HER2-directed ADC) in March 2019, and datopotamab deruxtecan (DS-1062; a TROP2-directed ADC) in July 2020, except in Japan where Daiichi Sankyo maintains exclusive rights.

Daiichi Sankyo is responsible for manufacturing and supply of Enhertu and datopotamab deruxtecan.

Driven by a growing understanding of breast cancer biology, AstraZeneca is starting to challenge, and redefine, the current clinical paradigm for how breast cancer is classified and treated to deliver even more effective treatments to patients in need with the bold ambition to one day eliminate breast cancer as a cause of death.
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