A Powerful Triple-Negative Breast Cancer Treatment Option
- Journalist Joan Lunden, 75, reflects on the emotional weight of her triple‑negative breast cancer diagnosis 12 years ago, sharing how uncertainty, difficult decisions, and the support of extraordinary doctors shaped her journey.
- Triple‑negative breast cancer lacks ER, PR, and HER2 receptors, making it harder to treat; chemotherapy — typically taxanes and anthracyclines — remains a standard treatment, especially for tumors over 0.5 cm or with lymph node involvement.
- A major clinical advance arrived recently with the FDA approval of datopotamab deruxtecan (Datroway), which has shown in the TROPION‑Breast02 clinical trial to extend survival by about five months for patients who aren’t candidates for surgery or immunotherapy.
- Datroway’s approval was based on results from the TROPION‑Breast02 Phase 3 trial, which showed the drug extending patient survival by about five months compared to standard chemotherapy and improving quality‑of‑life measures.
- “This is a meaningful step forward … better physical functioning, less pain, and overall better quality of life. That’s a win,” says Dr. Sarah Premji, Assistant Director of Breast Cancer Research at the Sarah Cannon Research Institute.
“I had no idea what the road ahead would look like,” Lunden shared in a reflective Instagram post.
Read MoreTriple‑negative breast cancer is defined by the absence of three key biomarkers — estrogen receptor (ER), progesterone receptor (PR), and HER2 — making it more difficult to treat.
“Any triple‑negative cancer that’s over half a centimeter or involves the lymph nodes needs chemotherapy,” explains medical oncologist Dr. Julie Nangia. Treatment typically involves two classes of chemotherapy, taxanes and anthracyclines, often given before surgery to shrink the tumor.
WATCH: Joan Lunden talks about parts of the journey often kept quiet.
For years, chemotherapy was the backbone of treatment. But now, following the FDA’s approval of datopotamab deruxtecan (Datroway), patients who are not candidates for surgery or immunotherapy have a new option. The approval is based on the TROPION‑Breast02 Phase 3 clinical trial, which showed Datroway extended survival by about five months compared with standard chemotherapy.
Datroway is an antibody‑drug conjugate, which is a targeted therapy that delivers chemotherapy directly to cancer cells.
WATCH: A Treatment Option for Triple-Negative Breast Cancer Patients
“This is a huge win for our metastatic triple‑negative breast cancer patients,” says Dr. Matt Kurian of St. Elizabeth’s Yung Family Cancer Center.
Dr. Sarah Premji of the Sarah Cannon Research Institute adds, “We’re seeing longer time before the cancer worsens, longer overall survival, and better patient‑reported outcomes. That’s a win.”
Reflecting on her own journey, Lunden acknowledged both the hardship and the strength it revealed.
“There were hard days, difficult decisions, and moments of uncertainty. But there was also incredible support, extraordinary doctors, and a reminder of just how resilient we can be,” she said.
Lunden’s Cancer Journey
Lunden co-hosted ABC’s “Good Morning America” for 17 years in the 1980s and 1970s. She was later a correspondent on NBC’s “TODAY” show, and it was during her time with “TODAY” that she learned of the cancer in her right breast. As remarkable as Lunden’s television career has been over the decades, equally as inspiring is her bravery surrounding her public breast cancer journey.
Lunden was diagnosed with triple-negative breast cancer in 2014. This type of cancer is not fueled by any of the three main types of receptors: estrogen, progesterone, or the HER2 protein.
Since triple-negative breast cancer is constantly unresponsive to certain targeted therapies, including hormone therapy or HER2-targeted agents like Herceptin, chemotherapy is typically the treatment, and there are several options.
“Any triple-negative cancer that’s over half a centimeter or has lymph node involvement needs chemotherapy,” Dr. Nangia explained to SurvivorNet.
Lunden’s cancer went nearly undetected because she has dense breasts, which means the breast has less fatty breast tissue, making it more difficult for mammograms alone to see the cancer. Women with dense breasts are encouraged to get an ultrasound alongside a mammogram to see any signs of cancer better.
Lunden’s husband, Jeff Konigsberg, shared that during her chemotherapy treatments, she helped others undergoing chemo alongside her.
“As Joan would go for a chemo session, she would go up to everybody else in the room who was receiving chemo; she wanted to know how they were doing and if they had that support. She just always cared about others,” he continued.
In a previous interview with SurvivorNet, Lunden shared that she knew little about breast cancer before she was diagnosed with it.
“Candidly,” says Lunden, “I never thought I would be one of the women who would get breast cancer.” Despite having to cope with her diagnosis, she managed to do it in stride. She’s since become a breast cancer advocate, offering hope and advice to other women battling the disease.
Datroway Leads To Strong Responses
Datroway was already approved for breast cancer patients who have hormone receptor-positive (HR+), HER2-negative (HER2-) metastatic breast cancer, which means the cancer cells have receptors for either estrogen and/or progesterone and do not over-express the HER2 protein. The new TNBC approval reflects the strength of the trial results.
“The totality of the evidence showed this drug is superior to standard chemotherapy,” Dr. Aditya Bardia, an oncologist at UCLA Health Jonsson Comprehensive Cancer Center, tells SurvivorNet.
The TROPION‑Breast02 study enrolled patients with previously untreated, locally recurrent, inoperable, or metastatic TNBC who were ineligible for immunotherapy. Participants were randomly assigned to Datroway and given the cancer drug intravenously every three weeks or to standard chemotherapy.
Among 644 patients treated between May 2022 and June 2024, the trial data revealed that:
- Progression-free survival, or the time before cancer began to progress, was 10.8 months with Datroway vs. 5.6 months with chemotherapy alone.
- Overall survival, or the average time that patients were still living, was 23.7 months with Datroway vs. 18.7 months with chemotherapy alone.
“The improvements in both progression‑free and overall survival — about five months — translate to a 43% reduction in the risk of disease progression or death,” says Dr. Eleonora Teplinsky, head of breast medical oncology at Valley Health System.
What This Means For Patients
“We now have strong data supporting the use of antibody‑drug conjugates, Datroway and Trodelvy, in the first‑line setting for metastatic TNBC patients who can’t receive immunotherapy,” Dr. Premji explains.
Antibody‑drug conjugates (ADC) work by pairing a highly targeted antibody with a cancer‑killing drug. Cancer cells are essentially linked to very powerful chemotherapies in a targeted way that will not harm nearby cells.
An ADC is built from three parts:
- A monoclonal antibody that finds the cancer cell
- A cytotoxic chemotherapy payload that kills it
- A chemical linker that binds the two together and controls when the payload is released.
Dr. Kurian says Datroway’s newly endorsed role by the National Comprehensive Cancer Network (NCCN) could meaningfully reshape first‑line care for a subset of metastatic triple‑negative breast cancer patients.
“Based on the updated NCCN guidelines, I expect Datroway to become a preferred first‑line option for metastatic triple‑negative breast cancer patients who aren’t eligible for immunotherapy alongside sacituzumab govitecan,” he explains.
“Both are strong agents with solid frontline efficacy, and while they share a TROP2 target, their payloads differ,” Dr. Kurian adds.
He believes that the next challenge will be its real-world application.
“We’re going to need more data on sequencing and how these drugs perform outside of trials, because community physicians now have two viable options — and that’s where the real decision‑making begins.”
Expert Resources for Triple-Negative Breast Cancer Patients
- Chemo for Triple Negative Breast Cancer
- Chemo Plus Immunotherapy for Metastatic Triple-Negative Breast Cancer
- In Triple Negative Breast Cancer, New Drug Trodelvy Extends Life
- Immunotherapy and Triple Negative Breast Cancer
- How to Treat Triple-Negative Breast Cancer: Keytruda Shows Promising Boost in Survival
- Metastatic Triple-Negative Breast Cancer Treatments To Consider
Managing Side Effects
Dr. Kurian says this approval could be a major shift for practicing physicians, especially compared to the long‑standing standard of care.
“I think this will have a huge impact. Our traditional single‑agent or doublet chemotherapy hasn’t been very effective, and it comes with significant toxicities, some of them permanent,” he explains. “Because of that, many patients never even make it to second‑ or third‑line options, given how aggressive their disease is.”
He emphasized that the new approval “gives [physicians] more sustainable options and creates durable responses we simply haven’t seen before in a disease with so few effective treatments.”
Datroway can cause side effects. During clinical studies, the most commonly reported reactions included:
- Stomatitis (mouth sores)
- Nausea and vomiting
- Fatigue
- Low blood cell counts (e.g., leukocytes, neutrophils, lymphocytes)
- Changes in liver enzymes (ALT, AST)
- Hair loss (alopecia)
- Eye-related symptoms (dry eye, keratitis)
If you or a loved one starts this treatment, it’s important to be vigilant for any notable side effects and tell your healthcare team immediately if they become problematic, especially eye problems.
Dr. Teplinsky tells SurvivorNet, “With antibody drug conjugates and specifically with Datroway, one of the side effects that people worry about is eye toxicity. They are recommended to make sure they see an eye doctor as soon as they start Datroway, and then there’s appropriate follow-up every so often to check the eyes, and there are protective eye drops that patients need to use.”
Early intervention can make a big difference in how well side effects are managed.
She says it’s important to understand what the side effects are and to be prepared for them. “So there are side effects of nausea, for example, making sure you’re having nausea medications that you can take at home, and things like that,” she adds.
Dr. Teplinsky further explains that a steroid mouth rinse for stomatitis and special medicated eye drops for eye toxicity are available.
Dr. Premji and Dr. Teplinsky note how important this approval is, as it offers hope for a subset of breast cancer patients in desperate need of improved outcomes.
Looking ahead, Dr. Premji says Datroway’s approval reflects a broader shift in oncology toward truly personalized care.
“The field is moving toward more individualized treatment based on the biology of each patient’s disease. We’re continually searching for markers that can predict who will benefit most from specific therapies and for ways to bring those insights earlier in the disease course to improve outcomes,” Dr. Premji says.
“As we study more investigational agents, our focus remains on finding the right treatment for the right patient and deepening our understanding of breast cancer,” Dr. Premji continues.
Finding Resources And Support
For patients and families navigating breast cancer or another serious illness like a cancer diagnosis, gaining access to new treatment or trials can feel overwhelming. That’s why SurvivorNet encourages patients to use its proprietary Clinical Trial Finder, a free tool designed to help patients identify relevant trials quickly and easily.
Every year, new early-phase studies come online, each one representing another step forward in disease management.
SurvivorNet’s AI-powered “My Health Questions” tool was also built with patient needs in mind, to give patients and their caregivers access to health information vetted by professionals right when they need it.
Learn more about SurvivorNet's rigorous medical review process.
