Trastuzumab Deruxtecan as Second-Line Treatment in HER2-Positive Gastric Cancer

Trastuzumab deruxtecan is approved in the U.S. for second- or later-line treatment and globally for third- or later-line treatment of human epidermal growth factor receptor 2 (HER2)–positive esophagogastric adenocarcinoma after disease progression on first-line trastuzumab-based treatment. Investigators now report results of the industry-sponsored, open-label, phase 3 DESTINY-Gastric04 trial of second-line treatment of unresectable or metastatic HER2-positive esophagogastric adenocarcinoma after disease progression on trastuzumab.

Patients with central confirmation of retained HER2-positive status received standard weekly paclitaxel and ramucirumab or trastuzumab deruxtecan every 3 weeks at 6.4 mg/kg. Of the 494 patients treated, 61% had gas…