# TUXEDO-1: trastuzumab deruxtecan in HER2-positive breast cancer with active brain metastases

Source: https://onco.cc/key-papers/paper-tuxedo-1-trastuzumab-deruxtecan-brain-metastases-nat-med-2022/  
OnCo record `paper-tuxedo-1-trastuzumab-deruxtecan-brain-metastases-nat-med-2022` (Key paper). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

In a small trial, the antibody-drug conjugate trastuzumab deruxtecan shrank brain metastases in almost three quarters of women with HER2-positive breast cancer, showing that a large antibody-based drug can work inside the brain.

## Summary

Single-arm phase 2 trial of 15 patients with HER2-positive breast cancer and newly diagnosed or progressing brain metastases not needing immediate local therapy, treated with trastuzumab deruxtecan 5.4 mg/kg.

Intracranial response by RANO-BM criteria was 73.3 percent in the intention-to-treat population, with a median progression-free survival of 14 months and preserved quality of life. The larger DESTINY-Breast12 study later confirmed intracranial activity in a broader population.

## Fields

- Kind: Key paper
- Last checked: 2026-09-17
- Journal: Nature Medicine
- Year: 2022
- DOI: 10.1038/s41591-022-01935-8
- Authors: Bartsch R, Berghoff AS, Furtner J, et al.
- Findings: Intracranial objective response 73.3 percent.; Median progression-free survival 14 months.
- What it means: Trastuzumab deruxtecan is an option for active HER2-positive brain metastases, complementing tucatinib-based therapy, and challenges the assumption that antibody-drug conjugates cannot reach the brain.
- Caveats: Very small single-centre study.; Patients with lesions needing urgent local treatment were excluded.

## Sources

- Nat Med 2022: https://doi.org/10.1038/s41591-022-01935-8
- PubMed: https://pubmed.ncbi.nlm.nih.gov/35941372/

## Connected records

- cancers: [HER2-positive breast cancer with brain metastases](https://onco.cc/cancers/her2-positive-breast-brain-metastases/)
- drugs: [Trastuzumab](https://onco.cc/drugs/trastuzumab/), [Trastuzumab deruxtecan](https://onco.cc/drugs/trastuzumab-deruxtecan/)
- trials: [TUXEDO-1](https://onco.cc/trials/tuxedo-1/)
- journals: [Nature Medicine](https://onco.cc/journals/nature-medicine/)

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