DESTINY-Gastric04: New Hope for HER2+ Gastric Cancer – The Babak Lab
The Babak Lab shared a post on LinkedIn about a paper by Kohei Shitara et al. published in NEJM:
“Clinical Mondays: DESTINY-Gastric04 – New Hope for HER2+ Gastric Cancer
A phase 3 NEJM study (July 2025) shows trastuzumab deruxtecan significantly improves OS vs. ramucirumab + paclitaxel in HER2+ metastatic gastric or GEJ cancer after trastuzumab.
Study Focus:
T-DXd (6.4 mg/kg) vs. Ram+Pac in 2L HER2⁺ mGC/GEJ post-trastuzumab
Trial Highlights (n=494):
- OS: 14.7 vs. 11.4 months (HR 0.70; p=0.004)
- PFS improved (HR 0.74)
- ORR: 44.3% vs. 29.1%
- Better DCR and DoR with T-DXd
Safety:
- Grade ≥3 AEs: 50.0% vs. 54.1%
- ILD/pneumonitis: 13.9%, mostly low-grade
Conclusion:
T-DXd is a superior 2L option for HER2⁺ gastric cancer-improving survival with manageable toxicity.
Image generated using Sora by OpenAI.”
Maria Babak, Head of The Babak Lab and Assistant Professor at City University of Hong Kong, shared this post, adding:
“Promising results from DESTINY-Gastric04!
Trastuzumab deruxtecan shows superior survival benefit in HER2⁺ metastatic gastric cancer compared to ramucirumab + paclitaxel.
A meaningful advance in second-line treatment options.”
Title: Trastuzumab Deruxtecan or Ramucirumab plus Paclitaxel in Gastric Cancer
Authors: Kohei Shitara, Eric Van Cutsem, Mahmut Gümüş, Sara Lonardi, Christelle de la Fouchardière, Clélia Coutzac, Jeroen Dekervel, Daniel Hochhauser, Lin Shen, Wasat Mansoor, Bo Liu, Lorenzo Fornaro, Min-Hee Ryu, Jeeyun Lee, Cátia Faustino, Jean-Philippe Metges, Josep Tabernero, Fábio Franke, Yelena Y. Janjigian, Fabricio Souza, Lori Jukofsky, Yumin Zhao, Takahiro Kamio, Aziz Zaanan, Filippo Pietrantonio
You can read the Full Article in NEJM.
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