Patient-reported outcomes show that datopotamab deruxtecan also improved patient functioning and symptom control compared to chemotherapy
Immunotherapy is not an option for around 70% of patients with locally recurrent inoperable or metastatic triple negative breast cancer (TNBC) (Oncologist. 2025 Mar 31;30(3):oyaf034 ). Datopotamab deruxtecan (Dato-DXd) – a trophoblast cell-surface antigen 2 (TROP2)-directed antibody-drug conjugate (ADC) – has recently emerged as an effective first-line monotherapy for these patients, demonstrating to significantly improve progression-free survival (PFS) and overall survival (OS) compared to standard chemotherapy in the phase III TROPION-Breast02 trial (Ann Oncol. 2026 Apr 3:S0923-7534(26)00130-4 ). Secondary endpoints data from the study, as presented at the ESMO Breast Cancer 2026 congress , also showed sustained improvements in patients’ symptoms, functioning and quality of life (QoL) (Abstract 415O ).
Patient reported outcomes (PROs) were assessed at baseline and throughout the study via electronic PRO questionnaires among the 644 patients involved in the study (n=323 receiving Dato-DXd arm; n=321 receiving chemotherapy by investigator’s choice). Secondary PRO endpoints included time to deterioration (TTD) in global health status (GHS)/QoL, physical functioning and pain using EORTC IL146, and in breast and arm symptoms using EORTC IL116. Exploratory PRO endpoints included TTD and change from baseline in symptoms and functioning using EORTC IL146/116, patient-reported symptomatic adverse events using PRO-CTCAE, EORTC IL147 and Mouth and Throat Symptoms Diary, and patient-reported treatment tolerability using PGI-TT. Overall, PROs data favoured Dato-DXd compared to chemotherapy, even though patients received the ADC monotherapy for longer (Figure).
According to Dr Ines Vaz-Luis from Gustave Roussy Cancer Center, Villejeuf, France, discussing the results during the congress, data presented offer an opportunity to reflect on how to integrate safety and quality of life into clinical decision-making. “Over the last 20 years, dozens of agents have been approved in breast cancer, creating a crowded therapeutic landscape where clinical and reimbursement decisions are increasingly complex,” she said. “So, when we select a drug for a patient, we have to put it in the context of the clinical benefit. Does this drug add time to OS and PFS but also to a better lived time? Does it preserve how patients feel and function? How does it preserve patients’ preferences?”
