Trastuzumab deruxtecan in patients from China with previously treated human epidermal growth factor receptor 2–positive locally advanced/metastatic gastric or gastroesophageal junction adenocarcinoma (DESTINY-Gastric06): results from a single-arm, multicenter, phase 2 trialResearch in context

Summary: Background: Trastuzumab deruxtecan (T-DXd; 6·4 mg/kg) is approved for metastatic human epidermal growth factor receptor 2 (HER2)–positive (HER2+) gastric or gastroesophageal junction (GEJ) adenocarcinoma after a trastuzumab-based regimen. We report the final analysis of DESTINY-Gastric06,...

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Main Authors: Zhi Peng, Ping Chen, Jin Lu, Yiye Wan, Yulong Zheng, Feng Ye, Jianwei Yang, Ying Liu, Hongming Pan, Meili Sun, Qingxia Fan, Ying Yuan, Kai Chen, Zhuoer Sun, Han Tian, Ye Xia, Lin Shen
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Language:English
Published: Elsevier 2025-09-01
Series:EClinicalMedicine
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Online Access:http://www.sciencedirect.com/science/article/pii/S2589537025003360
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author Zhi Peng
Ping Chen
Jin Lu
Yiye Wan
Yulong Zheng
Feng Ye
Jianwei Yang
Ying Liu
Hongming Pan
Meili Sun
Qingxia Fan
Ying Yuan
Kai Chen
Zhuoer Sun
Han Tian
Ye Xia
Lin Shen
author_facet Zhi Peng
Ping Chen
Jin Lu
Yiye Wan
Yulong Zheng
Feng Ye
Jianwei Yang
Ying Liu
Hongming Pan
Meili Sun
Qingxia Fan
Ying Yuan
Kai Chen
Zhuoer Sun
Han Tian
Ye Xia
Lin Shen
author_sort Zhi Peng
collection DOAJ
description Summary: Background: Trastuzumab deruxtecan (T-DXd; 6·4 mg/kg) is approved for metastatic human epidermal growth factor receptor 2 (HER2)–positive (HER2+) gastric or gastroesophageal junction (GEJ) adenocarcinoma after a trastuzumab-based regimen. We report the final analysis of DESTINY-Gastric06, evaluating T-DXd in pretreated patients from China with advanced HER2+ gastric cancers (GC). Methods: The single-arm, multicenter, phase 2 DESTINY-Gastric06 trial (NCT04989816) enrolled patients from China with HER2+ (immunohistochemistry [IHC] 3+ or IHC 2+; locally documented) advanced gastric or GEJ adenocarcinoma with two or more prior treatments. Patients received T-DXd 6·4 mg/kg intravenous infusion every 3 weeks. The primary endpoint was confirmed objective response rate in HER2+ (IHC 3+ or IHC 2+/in situ hybridization–positive) tumors (full analysis set) by independent central review. Secondary endpoints included investigator-assessed confirmed objective response rate, progression-free survival by independent central review, overall survival, and safety. Findings: Of 126 patients screened between August 20, 2021, and December 7, 2022, 95 were enrolled (intent-to-treat; 73 patients had centrally confirmed HER2+ tumors). Median follow up was 10·2 months. Among the 73 patients, confirmed objective response rate (95% confidence interval) by independent central review was 28·8% (18·8–40·6%) and by investigator assessment was 37·0% (26·0–49·1%). Median progression-free survival by independent central review was 5·7 months. Median overall survival was 11·1 months. The most common Grade 1–2 adverse event was white blood cell count decreased (53·7%; 51/95). Interpretation: Consistent with other GC trials, T-DXd showed durable benefit, with no new safety signals, in pretreated patients from China with HER2+ advanced GC; data support T-DXd as a third- or later-line therapeutic option in this population. Funding: AstraZeneca.
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spelling doaj-art-7eb9c79a603342e5a71edc428dc0b1d82025-08-20T03:36:49ZengElsevierEClinicalMedicine2589-53702025-09-018710340410.1016/j.eclinm.2025.103404Trastuzumab deruxtecan in patients from China with previously treated human epidermal growth factor receptor 2–positive locally advanced/metastatic gastric or gastroesophageal junction adenocarcinoma (DESTINY-Gastric06): results from a single-arm, multicenter, phase 2 trialResearch in contextZhi Peng0Ping Chen1Jin Lu2Yiye Wan3Yulong Zheng4Feng Ye5Jianwei Yang6Ying Liu7Hongming Pan8Meili Sun9Qingxia Fan10Ying Yuan11Kai Chen12Zhuoer Sun13Han Tian14Ye Xia15Lin Shen16State Key Laboratory of Holistic Integrative Management of Gastrointestinal Cancers, Beijing Key Laboratory of Carcinogenesis and Translational Research, Department of GI Oncology, Peking University Cancer Hospital & Institute, 52 Fucheng Road, Haidian District, Beijing, 100142, China; Corresponding author. Peking University Cancer Hospital & Institute, 52 Fucheng Road, Haidian District, Beijing, 100142, China.General Hospital of Ningxia Medical University, 692 Shengli St, Xingqing Qu, Yinchuan Shi Ningxia Huizuzizhiqu, Yinchuan, Ningxia, 750000, ChinaSichuan Cancer Hospital, 55 Renmin South Road, Section 4, Wuhou District, Chengdu, Sichuan, 610044, ChinaJiangxi Cancer Hospital, 519 East Beijing Road, 36, Nanchang, Jiangxi, 330029, ChinaThe First Affiliated Hospital Zhejiang University School of Medicine, 79 Qingchun Road, Hangzhou, Zhejiang, 310003, ChinaThe First Affiliated Hospital of Xiamen University, 55 Zhenhai Road, Siming District, Xiamen, 361003, ChinaFujian Cancer Hospital, 420 Fuma Road, Fuzhou, Fujian Province, 350014, ChinaHenan Cancer Hospital, 127 Dongming Road, Jinshui District, Zhengzhou, Henan, ChinaSir Run Run Shaw Hospital, Zhejiang University School of Medicine, East Qingchun Road, Shangcheng District, Hangzhou, Zhejiang, 310016, ChinaJinan Central Hospital, 105 Jiefang Road, Lixia District, Jinan, Shandong, 250013, ChinaThe First Affiliated Hospital of Zhengzhou University, 1 Jianshe East Road, Erqi District, Zhengzhou, Henan, 45005, ChinaDepartment of Medical Oncology, The Second Affiliated Hospital, Zhejiang University School of Medicine, 88 Jie Fang Rd, Shangcheng District, Hangzhou, Zhejiang, 310009, ChinaThe First Affiliated Hospital of Soochow University, 296 Shizi St, Cang Lang Qu, Suzhou, Jiangsu, 215005, ChinaOncology, Oncology R&D, AstraZeneca, No. 88, North Xizang Road, Jing'An District, Shanghai, 200071, ChinaOncology, Oncology R&D, AstraZeneca, No. 88, North Xizang Road, Jing'An District, Shanghai, 200071, ChinaOncology, Oncology R&D, AstraZeneca, No. 88, North Xizang Road, Jing'An District, Shanghai, 200071, ChinaState Key Laboratory of Holistic Integrative Management of Gastrointestinal Cancers, Beijing Key Laboratory of Carcinogenesis and Translational Research, Department of GI Oncology, Peking University Cancer Hospital & Institute, 52 Fucheng Road, Haidian District, Beijing, 100142, China; Corresponding author: Peking University Cancer Hospital & Institute, 52 Fucheng Road, Haidian District, Beijing, 100142, China.Summary: Background: Trastuzumab deruxtecan (T-DXd; 6·4 mg/kg) is approved for metastatic human epidermal growth factor receptor 2 (HER2)–positive (HER2+) gastric or gastroesophageal junction (GEJ) adenocarcinoma after a trastuzumab-based regimen. We report the final analysis of DESTINY-Gastric06, evaluating T-DXd in pretreated patients from China with advanced HER2+ gastric cancers (GC). Methods: The single-arm, multicenter, phase 2 DESTINY-Gastric06 trial (NCT04989816) enrolled patients from China with HER2+ (immunohistochemistry [IHC] 3+ or IHC 2+; locally documented) advanced gastric or GEJ adenocarcinoma with two or more prior treatments. Patients received T-DXd 6·4 mg/kg intravenous infusion every 3 weeks. The primary endpoint was confirmed objective response rate in HER2+ (IHC 3+ or IHC 2+/in situ hybridization–positive) tumors (full analysis set) by independent central review. Secondary endpoints included investigator-assessed confirmed objective response rate, progression-free survival by independent central review, overall survival, and safety. Findings: Of 126 patients screened between August 20, 2021, and December 7, 2022, 95 were enrolled (intent-to-treat; 73 patients had centrally confirmed HER2+ tumors). Median follow up was 10·2 months. Among the 73 patients, confirmed objective response rate (95% confidence interval) by independent central review was 28·8% (18·8–40·6%) and by investigator assessment was 37·0% (26·0–49·1%). Median progression-free survival by independent central review was 5·7 months. Median overall survival was 11·1 months. The most common Grade 1–2 adverse event was white blood cell count decreased (53·7%; 51/95). Interpretation: Consistent with other GC trials, T-DXd showed durable benefit, with no new safety signals, in pretreated patients from China with HER2+ advanced GC; data support T-DXd as a third- or later-line therapeutic option in this population. Funding: AstraZeneca.http://www.sciencedirect.com/science/article/pii/S2589537025003360HER2+T-DXdGastric cancerGastroesophageal junction adenocarcinoma
spellingShingle Zhi Peng
Ping Chen
Jin Lu
Yiye Wan
Yulong Zheng
Feng Ye
Jianwei Yang
Ying Liu
Hongming Pan
Meili Sun
Qingxia Fan
Ying Yuan
Kai Chen
Zhuoer Sun
Han Tian
Ye Xia
Lin Shen
Trastuzumab deruxtecan in patients from China with previously treated human epidermal growth factor receptor 2–positive locally advanced/metastatic gastric or gastroesophageal junction adenocarcinoma (DESTINY-Gastric06): results from a single-arm, multicenter, phase 2 trialResearch in context
EClinicalMedicine
HER2+
T-DXd
Gastric cancer
Gastroesophageal junction adenocarcinoma
title Trastuzumab deruxtecan in patients from China with previously treated human epidermal growth factor receptor 2–positive locally advanced/metastatic gastric or gastroesophageal junction adenocarcinoma (DESTINY-Gastric06): results from a single-arm, multicenter, phase 2 trialResearch in context
title_full Trastuzumab deruxtecan in patients from China with previously treated human epidermal growth factor receptor 2–positive locally advanced/metastatic gastric or gastroesophageal junction adenocarcinoma (DESTINY-Gastric06): results from a single-arm, multicenter, phase 2 trialResearch in context
title_fullStr Trastuzumab deruxtecan in patients from China with previously treated human epidermal growth factor receptor 2–positive locally advanced/metastatic gastric or gastroesophageal junction adenocarcinoma (DESTINY-Gastric06): results from a single-arm, multicenter, phase 2 trialResearch in context
title_full_unstemmed Trastuzumab deruxtecan in patients from China with previously treated human epidermal growth factor receptor 2–positive locally advanced/metastatic gastric or gastroesophageal junction adenocarcinoma (DESTINY-Gastric06): results from a single-arm, multicenter, phase 2 trialResearch in context
title_short Trastuzumab deruxtecan in patients from China with previously treated human epidermal growth factor receptor 2–positive locally advanced/metastatic gastric or gastroesophageal junction adenocarcinoma (DESTINY-Gastric06): results from a single-arm, multicenter, phase 2 trialResearch in context
title_sort trastuzumab deruxtecan in patients from china with previously treated human epidermal growth factor receptor 2 positive locally advanced metastatic gastric or gastroesophageal junction adenocarcinoma destiny gastric06 results from a single arm multicenter phase 2 trialresearch in context
topic HER2+
T-DXd
Gastric cancer
Gastroesophageal junction adenocarcinoma
url http://www.sciencedirect.com/science/article/pii/S2589537025003360
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