Breast cancer (invasive) · line 2 · T-DXd monotherapy (HER2+ metastatic 2L+, also HER2-low metastatic)
Deterministic view of the source YAML entity. Clinical authority remains with the cited source IDs and reviewer sign-off state.
Knowledge-base record for audit. Provisional clinical content: this is not a prescription. An oncologist must verify original sources, applicability and review status. Full rules and constraints are in the YAML.
| Line of therapy | 2 |
|---|---|
| Track | standard |
| Linked regimen | REG-TDXD-METASTATIC |
| ID | IND-BREAST-TNBC-2L-T-DXD-HER2-LOW |
|---|---|
| Type | Indication |
| Status | reviewed 2026-04-27 | pending_clinical_signoff |
| Diseases | DIS-BREAST |
| Sources | SRC-DESTINY-BREAST04-MODI-2022 SRC-ESMO-BREAST-METASTATIC-2024 SRC-NCCN-BREAST-2025 |
Notes
ESCAT IA. DESTINY-Breast04 included a small TNBC HER2-low cohort (n=63) with consistent benefit signal — T-DXd should be preferred over sacituzumab when HER2-low confirmed (IHC 1+ or IHC 2+/ISH-). When HER2-IHC = 0, sacituzumab govitecan (ASCENT) is the default ≥2L. ILD risk dominant safety concern — baseline CT chest + active monitoring. UA access barrier: T-DXd registered but reimbursement under negotiation. Sequencing question (T-DXd then sacituzumab vs reverse) is unsettled; ALGO-BREAST-TNBC-2L defaults to T-DXd-first for HER2-low.
Used By
Algorithms
ALGO-BREAST-TNBC-2L- ALGO-BREAST-TNBC-2L