Researchers are hoping to find a new alternative to traditional chemotherapy to help treat HER2-positive metastatic gastric cancer, with later line treatments providing limited results which also take a toll on already fragile patients. 

Results of the phase II DESTINY-Gastric01 trial showed trastuzumab deruxtecan can improve overall response and survival rates, while also avoiding some of the more extreme side effects of chemotherapy. 

Suneel Kamath, MD, of the Cleveland Clinic told MD/alert that the trial results are encouraging for doctors and patients alike. 

Dr Kamath was not involved in the research but said the 41% reduction in the risk of death and other results could be a game-changer for the field. 

“We’re very excited about this agent. I think having a response rate of 43% essentially with many complete responses is definitely unheard of in this disease, and certainly nothing you’d see with chemotherapy," he said. 

The 42.9% overall response rate was significantly better than the 12.5% rate with either paclitaxel or irinotecan, according to a press release from the manufacturer. There were also 10 complete responses in the treatment arm compared to zero in the chemo arm, as well as 41 partial responses with the drug compared to seven in the chemo group.   

Trastuzumab deruxtecan is also being investigated as a possible treatment for colorectal cancer and breast cancer. Dr Kamath said one of the most significant advantages they’ve seen across the trials is the ability of the drug to help patients who have had prior HER2 therapy.  

He also said giving patients a treatment option that isn’t using the traditional chemotherapy agents is also an advantage for patients who might otherwise not have many other options.  

One area where Dr Kamath said potentially prescribing doctors will need to pay attention is the risk of interstitial lung disease. 

While interstitial lung disease is a serious risk to consider, Dr Kamath said with few other options available, it is something that should still be strongly considered to help patients.    

By Adam Hochron