Dr. Janjigian on the Expanding Treatment Armamentarium in HER2+ Gastric Cancer

Yelena Y. Janjigian, MD, a medical oncologist at Memorial Sloan Kettering Cancer Center, discusses the expanding treatment armamentarium in HER2-positive gastric cancer. 

Currently, trastuzumab (Herceptin) in combination with chemotherapy remains the first-line standard of care for patients with HER2-positive, metastatic gastric cancer based on the results of the phase 3 ToGA trial, Janjigian explains. Over the past few years, several clinical trials have yielded negative findings in this space, including those evaluating lapatinib (Tykerb) plus chemotherapy in the frontline setting, pertuzumab (Perjeta) plus trastuzumab in the frontline setting, and ado-trastuzumab emtansine (Kadcyla; T-DM1) in the second-line setting.

However, findings from the phase 2 DESTINY-Gastric01 trial showed an improvement in objective response rate and overall survival with the antibody-drug conjugate fam-trastuzumab deruxtecan-nxki (Enhertu) in patients with previously treated HER2-positive gastric cancer. Additionally, therapies, such as tucatinib (Tukysa) plus trastuzumab, margetuximab-cmkb (Margenza), and the combination of trastuzumab and pembrolizumab (Keytruda) are currently in the pipeline for HER2-positive gastric cancer, concludes Janjigian.