High complete response rates with Dato-DXd and durvalumab in immune-positive subtypes
Results published in Nature Medicine show the antibody-drug conjugate Dato-DXd combined with durvalumab produced high pathologic complete response rates in immune-positive and triple-negative subtypes — with the trial's SMART design enabling real-time treatment tailoring based on tumor biology.
Published in Nature Medicine and featured by Inside Precision Medicine, new findings from the I-SPY 2.2 trial demonstrate the potential of combining the antibody-drug conjugate Dato-DXd with the immunotherapy durvalumab to improve outcomes for patients with high-risk early-stage breast cancer. The study reported high pathologic complete response (pCR) rates among patients with immune-positive and triple-negative breast cancer subtypes. These encouraging results suggest that targeted treatment combinations can deliver strong responses while reducing reliance on traditional chemotherapy for carefully selected patients. A key innovation of the trial is its SMART (Sequential Multiple Assignment Randomized Trial) design, which allows treatments to be adapted in real time based on each patient's tumor biology and response to therapy. This flexible approach enables researchers to identify the most effective treatment strategies more quickly and personalize care throughout the course of treatment. By integrating advanced molecular profiling with adaptive clinical trial methods, I-SPY 2.2 continues to accelerate the development of precision medicine. The findings reinforce the potential of biomarker-driven therapies to improve response rates, minimize unnecessary treatment, and deliver more individualized care for patients with breast cancer.