{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T09:29:41Z","timestamp":1787045381017,"version":"build-2736575974"},"reference-count":26,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T00:00:00Z","timestamp":1787011200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Science Foundation of Peking University Cancer Hospital","award":["ZY202510"],"award-info":[{"award-number":["ZY202510"]}]},{"award":["ZY202510"],"award-info":[{"award-number":["ZY202510"]}],"id":[{"id":"https:\/\/ror.org\/00nyxxr91","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Curr. Oncol.","Current Oncology"],"abstract":"<jats:p>We retrospectively analyzed consecutive patients with HER2-positive metastatic breast cancer who received T-DXd at a single Chinese cancer center between March 2023 and March 2026. Progression-free survival (PFS), overall survival (OS), systemic and intracranial response, safety, prognostic factors, and exploratory subsequent treatment strategies were assessed. Among 173 eligible patients, 80.3% had received prior HER2-directed TKIs and 41.6% had CNS metastases. After a median follow-up of 14.3 months, median PFS and OS were 14.1 and 31.1 months, respectively. The objective response rate was 54.5% among 154 patients with measurable systemic disease, while the CNS objective response rate was 46.3% among 67 patients with measurable CNS lesions. Among patients with measurable CNS lesions, the CNS-ORR was comparable between patients with and without peri-T-DXd local treatment (53.8% vs. 44.4%, p = 0.21). Greater prior treatment exposure was associated with shorter PFS, whereas HER2 IHC 3+ disease was independently associated with longer OS and showed a trend toward improved PFS compared with HER2 IHC 2+\/FISH-positive disease. Interstitial lung disease occurred in 13 patients (7.5%), all grade 1\u20132. Among 148 patients included in the maintenance analysis, 23 switched to alternative maintenance regimens after initial benefit from T-DXd. In an exploratory analysis, no statistically significant differences in PFS or OS were observed between patients who continued T-DXd and those who switched to maintenance therapy. However, these findings require cautious interpretation because of immortal-time bias, selection bias, and limited sample size. T-DXd demonstrated clinically meaningful systemic and intracranial activity with manageable toxicity in this heavily pretreated real-world cohort.<\/jats:p>","DOI":"10.3390\/curroncol33080487","type":"journal-article","created":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T08:08:41Z","timestamp":1787040521000},"page":"487","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Trastuzumab Deruxtecan in HER2-Positive Metastatic Breast Cancer: Real-World Outcomes and Treatment Transition Patterns in a Chinese Cohort"],"prefix":"10.3390","volume":"33","author":[{"given":"Yifei","family":"Chen","sequence":"first","affiliation":[{"name":"Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education\/Beijing), Department of Breast Oncology, Peking University Cancer Hospital & Institute, Beijing 100142, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruyan","family":"Zhang","sequence":"additional","affiliation":[{"name":"Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education\/Beijing), Department of Breast Oncology, Peking University Cancer Hospital & Institute, Beijing 100142, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ran","family":"Ran","sequence":"additional","affiliation":[{"name":"Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education\/Beijing), Department of Breast Oncology, Peking University Cancer Hospital & Institute, Beijing 100142, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6024-3560","authenticated-orcid":false,"given":"Yaxin","family":"Liu","sequence":"additional","affiliation":[{"name":"Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education\/Beijing), Department of Breast Oncology, Peking University Cancer Hospital & Institute, Beijing 100142, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiayang","family":"Zhang","sequence":"additional","affiliation":[{"name":"Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education\/Beijing), Department of Breast Oncology, Peking University Cancer Hospital & Institute, Beijing 100142, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ying","family":"Yan","sequence":"additional","affiliation":[{"name":"Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education\/Beijing), Department of Breast Oncology, Peking University Cancer Hospital & Institute, Beijing 100142, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bin","family":"Shao","sequence":"additional","affiliation":[{"name":"Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education\/Beijing), Department of Breast Oncology, Peking University Cancer Hospital & Institute, Beijing 100142, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xu","family":"Liang","sequence":"additional","affiliation":[{"name":"Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education\/Beijing), Department of Breast Oncology, Peking University Cancer Hospital & Institute, Beijing 100142, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hanfang","family":"Jiang","sequence":"additional","affiliation":[{"name":"Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education\/Beijing), Department of Breast Oncology, Peking University Cancer Hospital & Institute, Beijing 100142, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lijun","family":"Di","sequence":"additional","affiliation":[{"name":"Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education\/Beijing), Department of Breast Oncology, Peking University Cancer Hospital & Institute, Beijing 100142, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guohong","family":"Song","sequence":"additional","affiliation":[{"name":"Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education\/Beijing), Department of Breast Oncology, Peking University Cancer Hospital & Institute, Beijing 100142, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3331-647X","authenticated-orcid":false,"given":"Huiping","family":"Li","sequence":"additional","affiliation":[{"name":"Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education\/Beijing), Department of Breast Oncology, Peking University Cancer Hospital & Institute, Beijing 100142, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,8,18]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1016\/S0140-6736(22)02420-5","article-title":"Trastuzumab deruxtecan versus trastuzumab emtansine in patients with HER2-positive metastatic breast cancer: Updated results from DESTINY-Breast03, a randomised, open-label, phase 3 trial","volume":"401","author":"Hurvitz","year":"2023","journal-title":"Lancet"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"551","DOI":"10.1056\/NEJMoa2508668","article-title":"Trastuzumab Deruxtecan plus Pertuzumab for HER2-Positive Metastatic Breast Cancer","volume":"394","author":"Tolaney","year":"2026","journal-title":"N. Engl. J. Med."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1840","DOI":"10.1038\/s41591-022-01935-8","article-title":"Trastuzumab deruxtecan in HER2-positive breast cancer with brain metastases: A single-arm, phase 2 trial","volume":"28","author":"Bartsch","year":"2022","journal-title":"Nat. Med."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"3717","DOI":"10.1038\/s41591-024-03261-7","article-title":"Trastuzumab deruxtecan in HER2-positive advanced breast cancer with or without brain metastases: A phase 3b\/4 trial","volume":"30","author":"Harbeck","year":"2024","journal-title":"Nat. Med."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1348","DOI":"10.1200\/OP.23.00794","article-title":"Breast Cancer Brain Metastasis: A Comprehensive Review","volume":"20","author":"Raghavendra","year":"2024","journal-title":"JCO Oncol. Pract."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"oyaf174","DOI":"10.1093\/oncolo\/oyaf174","article-title":"Prognostic index for predicting outcomes of trastuzumab deruxtecan in HER2 expressing metastatic breast cancer: A real-world multicenter study","volume":"30","author":"Xue","year":"2025","journal-title":"Oncologist"},{"key":"ref_7","first-page":"101455","article-title":"Real-world efficacy and safety of trastuzumab deruxtecan versus trastuzumab emtansine and tucatinib as second-line and third-line treatments for HER2-positive metastatic breast cancer: Two target trial emulation studies","volume":"58","author":"Jourdain","year":"2025","journal-title":"Lancet Reg. Health-Eur."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"303","DOI":"10.1093\/oncolo\/oyad308","article-title":"Real-World Outcomes of Trastuzumab Deruxtecan in Patients with HER2+ Metastatic Breast Cancer: The DE-REAL Study","volume":"29","author":"Botticelli","year":"2024","journal-title":"Oncologist"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1773","DOI":"10.1016\/S0140-6736(23)00725-0","article-title":"Trastuzumab deruxtecan versus treatment of physician\u2019s choice in patients with HER2-positive metastatic breast cancer (DESTINY-Breast02): A randomised, open-label, multicentre, phase 3 trial","volume":"401","author":"Kim","year":"2023","journal-title":"Lancet"},{"key":"ref_10","unstructured":"U.S. Food and Drug Administration (2026, April 27). FDA Approves Fam-Trastuzumab Deruxtecan-Nxki with Pertuzumab for Unresectable or Metastatic HER2-Positive Breast Cancer, Available online: https:\/\/www.fda.gov\/drugs\/drug-approvals-and-databases\/fda-approves-fam-trastuzumab-deruxtecan-nxki-pertuzumab-unresectable-or-metastatic-her2-positive."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1038\/s41523-025-00841-9","article-title":"Real-world outcomes of trastuzumab deruxtecan in HR-negative HER2-low metastatic breast cancer","volume":"11","author":"Ni","year":"2025","journal-title":"NPJ Breast Cancer"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"235","DOI":"10.1158\/2159-8290.CD-25-0647","article-title":"Trastuzumab Deruxtecan Resistance via Loss of HER2 Expression and Binding","volume":"16","author":"Chen","year":"2026","journal-title":"Cancer Discov."},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Zhou, S., Qin, X., Xing, W., Xu, Z., Wei, C., Ren, Y., and Gong, Z. (2025). Differences in treatment response and survival between HER2(2+)\/FISH-positive and HER2(3+) breast cancer patients after dual-target neoadjuvant therapy: A matched case-control study. Front. Oncol., 15.","DOI":"10.3389\/fonc.2025.1530793"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1007\/s10549-019-05295-9","article-title":"Pathologic complete response rate according to HER2 detection methods in HER2-positive breast cancer treated with neoadjuvant systemic therapy","volume":"177","author":"Xu","year":"2019","journal-title":"Breast Cancer Res. Treat."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"82","DOI":"10.1038\/s41523-023-00584-5","article-title":"Treatment with trastuzumab deruxtecan in patients with HER2-positive breast cancer and brain metastases and\/or leptomeningeal disease (ROSET-BM)","volume":"9","author":"Niikura","year":"2023","journal-title":"NPJ Breast Cancer"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"353","DOI":"10.1016\/S1470-2045(21)00716-6","article-title":"Pyrotinib plus capecitabine for patients with human epidermal growth factor receptor 2-positive breast cancer and brain metastases (PERMEATE): A multicentre, single-arm, two-cohort, phase 2 trial","volume":"23","author":"Yan","year":"2022","journal-title":"Lancet Oncol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"17731","DOI":"10.1038\/s41598-025-02550-6","article-title":"Efficacy and safety of trastuzumab deruxtecan in HER2-positive breast cancer patients with brain metastases after failure of pyrotinib-based therapy","volume":"15","author":"Zhou","year":"2025","journal-title":"Sci. Rep."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1038\/s41698-025-00801-3","article-title":"Real life outcome analysis of breast cancer brain metastases treated with Trastuzumab Deruxtecan","volume":"9","author":"Fabi","year":"2025","journal-title":"npj Precis. Oncol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1186\/s13058-025-02088-5","article-title":"Trastuzumab deruxtecan in patients with active brain metastases from HER2-positive\/low metastatic breast cancer: A retrospective multicenter real-world study","volume":"27","author":"Duan","year":"2025","journal-title":"Breast Cancer Res."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"104421","DOI":"10.1016\/j.breast.2025.104421","article-title":"Safety and efficacy of combined trastuzumab-deruxtecan and concurrent radiation therapy in breast cancer. The TENDANCE multicentric French study","volume":"80","author":"Debbi","year":"2025","journal-title":"Breast"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"104691","DOI":"10.1016\/j.breast.2026.104691","article-title":"Concomitant radiation therapy and trastuzumab deruxtecan in metastatic breast cancer: Feasibility, safety, and outcomes from a real-life multicentre international cohort","volume":"85","author":"Visani","year":"2026","journal-title":"Breast"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"580","DOI":"10.1097\/COC.0000000000001135","article-title":"Concurrent Use of Trastuzumab Deruxtecan and Radiation Therapy in HER2-Positive and HER2-Low Metastatic Breast Cancer: A Single-Center Experience and Review of the Literature","volume":"47","author":"Bouziane","year":"2024","journal-title":"Am. J. Clin. Oncol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"e2500498","DOI":"10.1200\/GO-25-00498","article-title":"Concurrent New Systemic Therapies and Radiation Therapy in Breast Cancer: Current Evidence, Future Challenges, and Expert Practice Recommendations for Low- and Middle-Income Countries","volume":"12","author":"Debbi","year":"2026","journal-title":"JCO Glob. Oncol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"451","DOI":"10.1056\/NEJMoa2511218","article-title":"Palbociclib for Hormone-Receptor\u2013Positive, HER2-Positive Advanced Breast Cancer","volume":"394","author":"Metzger","year":"2026","journal-title":"N. Engl. J. Med."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1021","DOI":"10.1200\/JCO.2026.44.16_suppl.1021","article-title":"A DESTINY-Breast09 analysis of treatment duration and clinical outcomes by best response to trastuzumab deruxtecan (T-DXd) + pertuzumab (P)","volume":"44","author":"Park","year":"2026","journal-title":"J. Clin. Oncol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"458","DOI":"10.47102\/annals-acadmedsg.202576","article-title":"Evaluating the impact of relative dose intensity on efficacy of trastuzumab deruxtecan for metastatic breast cancer in the real-world clinical setting","volume":"54","author":"Lee","year":"2025","journal-title":"Ann. Acad. Med. Singap."}],"container-title":["Current Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1718-7729\/33\/8\/487\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T08:51:19Z","timestamp":1787043079000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1718-7729\/33\/8\/487"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,18]]},"references-count":26,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2026,8]]}},"alternative-id":["curroncol33080487"],"URL":"https:\/\/doi.org\/10.3390\/curroncol33080487","relation":{},"ISSN":["1718-7729"],"issn-type":[{"value":"1718-7729","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,18]]}}}