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AstraZeneca, Daiichi's breast cancer drug gets FDA nod as first-line treatment

FDA approval follows DESTINY-Breast09 trial showing 44% reduced progression risk and median progression-free survival of 40.7 months with Enhertu plus pertuzumab.

  • On Monday the U.S. Food and Drug Administration approved ENHERTU with pertuzumab as a first-line treatment for adults with unresectable or metastatic HER2-positive breast cancer.
  • Presented earlier this year, DESTINY‑Breast09 showed T‑DXd plus pertuzumab reduced progression risk by 44% and achieved a median PFS of 40.7 months versus 26.9 months with THP.
  • In the DESTINY‑Breast09 safety analysis, the confirmed objective response rate was 87% with 15% complete responses, while interstitial lung disease occurred in about 12% and serious adverse reactions in 27% of patients.
  • The approval could reshape prescribing by introducing the first new first‑line option for HER2‑positive metastatic breast cancer in more than a decade, affecting approximately 10,000 U.S. first‑line patients and triggering a $150 million milestone payment to Daiichi Sankyo amid ENHERTU sales growth this year.
  • FDA also cleared companion diagnostics for HER2 status, the ENHERTU label requires Boxed WARNINGS for ILD/pneumonitis and embryo‑fetal toxicity with monitoring, and Project Orbis reviews plus confirmatory trials mean continued approval is conditional while OS data are immature.
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cancernetwork.com broke the news in on Monday, December 15, 2025.
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