Dr. Marshall on the Potential Utility of Trastuzumab Deruxtecan in HER2+ Gastric Cancer

John L. Marshall, MD, chief, Division of Hematology/Oncology, Medstar Georgetown University Hospital, professor, Medicine and Oncology, Lombardi Comprehensive Cancer Center, Georgetown University, Director, Otto J. Ruesch Center for the Cure of Gastrointestinal Cancer, discusses the potential utility of fam-trastuzumab deruxtecan-nxki (Enhertu) in HER2-positive gastric cancer.

An FDA approval for trastuzumab deruxtecan is fully anticipated in this patient population and, moreover, the antibody-drug conjugate is expected to become a new standard of care, Marshall says. Currently, second-line options for patients with HER2-positive gastric cancer include single-agent taxane-based treatment, ramucirumab (Cyramza), paclitaxel, and irinotecan, Marshall adds.

This drug is associated with some adverse effects, including interstitial lung disease. Although the toxicity is rare, it is important to monitor patients who receive the agent, Marshall continues. Despite the risk of toxicity, the response rate observed with trastuzumab deruxtecan is approaching 40% in patients with HER2-positive gastric cancer, suggesting the efficacy tradeoff will be in favor of trying the agent in clinical practice, Marshall concludes.