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Trastuzumab deruxtecan showed similar clinical benefit for frail HER2 positive gastric cancer patients: Retrospective observational study
Background
Trastuzumab deruxtecan(T-DXd) showed promising effect for HER2 positive advanced gastric cancer (AGC) patients who previously received two or more chemotherapy in DESTINY-Gastric01 trial. Few HER2-positive AGC patients can receive T-DXd after third-line or later line treatment. In addition, although there are many frail cases in AGC patients receiving third-line treatment, the effectiveness and safety of T-DXd for frail cases is not yet clear.
Methods
In this multicenter retrospective study, we collected clinical data of HER2 positive AGC patients received T-DXd from Electronic medical record system. Frail is defined as 75 years or older with any PS.
Results
19 AGC patients were received T-DXd after two or more prior chemotherapy. Frail patients were 6 patients (32%). There is no significant difference between frail and non-frail group in patients background. In all patients, response rate (RR) was 42%, disease control rate was 78%, median progression free survival (PFS) was 4 months (95% CI: 2.6-6.5) and median overall survival (OS) was 6.1 months (95%CI:3.7-9.4). There were no significantly difference in RR, DCR, PFS, OS between frail group and non-frail group. There was no significant difference in safety between frail and non-frail patients. However, dose reduction was required at 47% in all population and frail group tended to have more dose reductions (67% vs 38%). In the frail group, 3 cases of dose reduction from the initial administration were observed. No patients in the frail group could receive post therapy after T-DXd failure.
Conclusions
T-DXd showed clinical benefit for AGC patients in clinical setting including frail patients. However, dose reduction was necessary in about 50% of all population, and there was a tendency that dose reduction was more often required in frail patients. Further large study including frail patients is needed.
Legal entity responsible for the study
The author.
Funding
Has not received any funding.
Disclosures
H. Yasui: Honoraria (self): Daiichi Sankyo, Ono Pharmaceutical, Taiho Pharmaceutical, Chugai Pharma, Bristol-Myers Squibb Japan, TERUMO, Eli Lilly Japan, Merk Biopharma, Yakult Honsha, Bayer Yakuhin, Takeda Pharmaceutical; Research grant / Funding (self): MSD, Ono Pharmaceutical, Daiichi Sankyo, Astellas Pharma. H. Satake: Honoraria (self): Ono pharmaceutical co., ltd., Daiichi Sankyo Co., Ltd., Eli Lilly Japan Co., Ltd., Merck Bio Pharma Co., Ltd., MSD Co., Ltd., Bayer Co., Ltd., Bristol-Myers Squibb Co., Ltd., Chugai Pharmaceutical Co., Ltd., Sanofi Co., Ltd., Taiho Pharmaceutical Co., Ltd., Takeda Co., Ltd. and Yakult Honsha Co., Ltd.; Research grant / Funding (institution): Ono pharmaceutical co., ltd., Daiichi Sankyo, Takeda Pharmaceutical Co., Ltd., Sanofi, Taiho Pharmaceutical Co., Ltd. All other authors have declared no conflicts of interest.
