The disclosure of the clinical trial of Trastuzumab deruxtecan (T-DXd) for the pretreatment of patients (pts) with her2-expressing solid tumors at ESMO 2023 provides the factual basis for subsequent, more in-depth studies.
Fam-trastuzumab deruxtecan-NXKI is a drug classified as a monoclonal antibody and an antibody drug conjugate (ADC). It targets HER2 and TOP1, making it suitable for the treatment of various diseases. The drug has shown potential in therapeutic areas such as neoplasms, nervous system diseases, digestive system disorders, endocrinology and metabolic disease, skin and musculoskeletal diseases, urogenital diseases, and respiratory diseases.
According to the Patsnap Synapse, Fam-trastuzumab deruxtecan-NXKI was developed by Daiichi Sankyo Co., Ltd., and it has received approval for use in the highest phase in both global and Chinese markets. And the clinical trial areas for Fam-trastuzumab deruxtecan-NXKI are primarily in the United States, China, and United Kingdom. The key indication is Neoplasms.
This open-label, Phase 2 study (NCT04482309) evaluated T-DXd (5.4 mg/kg Q3W) in pts with HER2-expressing (immunohistochemistry [IHC] 3+/2+ by local or central testing), locally advanced/metastatic disease after ≥1 systemic treatment (Tx), or without alternative Tx options.
In this study, primary endpoint was investigator-assessed confirmed ORR. Secondary endpoints included safety, DOR, PFS and OS.
The result showed that at data cut off (Jun 2023), 267 pts with biliary tract (BTC), bladder (URO), cervical (CC), endometrial (EC), ovarian (OC), pancreatic (PC), or other tumors had received Tx (median [m] follow up: 12.75 [range 0.4–31.6] months [mo]); 72.3% received ≥2 prior lines of therapy. In all pts, investigator-assessed ORR (95% CI) was 37.1% (31.3, 43.2); mDOR (95% CI) was 11.3 mo (9.6, 17.8); mPFS (95% CI) was 6.9 mo (5.6, 8.0); and mOS (95% CI) was 13.4 mo (11.9, 15.5). In pts with IHC 3+ expression (central; n=75) ORR was 61.3% (49.4, 72.4); mDOR was 22.1 mo (9.6, not reached); mPFS was 11.9 mo (8.2, 13.0); and mOS was 21.1 mo (15.3, 29.6). Table shows ORR, PFS and OS by tumor type in all pts and IHC 3+. Grade (G) ≥3 Tx-related adverse events (AEs) occurred in 40.8% of pts; 8.6% discontinued Tx due to Tx-related AEs. Adjudicated Tx-related interstitial lung disease/pneumonitis occurred in 10.5% (n=28) of pts (9.0% [n=24] G≤2; 1.1% [n=3] G5).
It can be concluded that T-DXd has a durable effect and clinically meaningful PFS and OS in pretreated pts across HER2-expressing tumors, with safety consistent with the known profile. These data support T-DXd as a potential tumor-agnostic treatment in HER2-expressing tumors.
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