Study
| International, randomized, open-label, phase 3 trial (DESTINY-Gastric04) |
| HER2-positive metastatic gastric or GE junction adenoCa after trastuzumab-based therapy |
| Trastuzumab deruxtecan 6.4 mg/kg q3w vs. Ramucirumab + Paclitaxel |
Efficacy
| ORR: 44.3% vs. 29.1% (p<0.001) |
| mDoR: 7.4 mos vs. 5.3 mos |
| mPFS: 6.7 mos vs. 5.6 mos (HR: 0.74 [0.59-0.92]) |
| mOS: 14.7 mos vs. 11.4 mos (HR: 0.70 [0.55-0.90]) |
| 1-yr OS: 57.6% vs. 48.9% |
Safety
| Grade ≥3 AEs: neutropenia (28.7% vs. 35.6%), anemia (13.9% vs. 13.7%) |
| Interstitial lung disease/pneumonitis: 13.9% vs. 1.3% |
| Discontinuation due to AEs: 11.5% vs. 13.3% |
N Engl J Med. Published May 31, 2025
http://doi.org/10.1056/NEJMoa2503119
Reviewed by Ulas D. Bayraktar, MD on Jun 2, 2025
