Dr. Janjigian on Updated Results from the DESTINY-Gastric01 Trial in HER2+ Gastric Cancer

Yelena Y. Janjigian, MD, a medical oncologist at Memorial Sloan Kettering Cancer Center, discusses updated results from the ​phase 2 DESTINY-Gastric01 trial​ in previously treated patients with HER2-positive gastric cancer.

The multicenter study was conducted in Asia where heavily pretreated patients ​with HER2-positive disease were randomized to receive either chemotherapy or fam-trastuzumab deruxtecan-nxki (T-DXd; Enhertu). Despite the challenges, the overall response rate was remarkable, says Janjigian. Notably, the overall response rate was 51% ​with T-DXd versus 14% with chemotherapy. The median overall survival was at 12.5 months ​and 8.4 months, respectively.

These data compare favorably to several other standards of care, Janjigian explains. Moreover, due to the exciting data, a breakthrough therapy designation was granted to T-DXd by the FDA for the treatment of patients with HER2-positive unresectable or metastatic gastric or gastroesophageal junction adenocarcinoma.

This would be extremely beneficial to our patients in the 3rd line setting, Janjigian exclaims. The risk of pulmonary toxicity is an area of concern with T-DXd as grade 5 treatment-related adverse events (TRAEs), including interstitial lung disease, have been observed in patients with HER2-positive breast cancer and colorectal cancer.