T-DXd Efficacy in Various Solid Tumors

Основні поняття

T-DXd shows promising efficacy in treating various solid tumors expressing HER2.

Анотація

The content discusses the efficacy of Trastuzumab deruxtecan (T-DXd) in treating a wide range of solid tumors expressing HER2. The ongoing DESTINY-PanTumor02 trial revealed positive results across different tumor types, indicating a potential shift in cancer care. Key highlights include:

• T-DXd efficacy in HER2-expressing metastatic breast, gastroesophageal, and lung cancers.
• Preliminary data suggesting T-DXd effectiveness in advanced solid tumors like cervix, endometrium, ovaries, and bladder.
• Objective response rates (ORR) among patients with various solid tumors.
• Durable responses with T-DXd treatment.
• Potential for tumor-agnostic development of T-DXd.
• Importance of accurate HER2 testing for treatment decisions.
• Safety profile and common adverse events associated with T-DXd.
• Ongoing DESTINY-PanTumor02 trial funded by Daiichi-Sankyo.

Статистика

Among 267 patients with solid tumors, the investigator-assessed ORR was 37.1%.
ORR for patients with HER2 IHC scores of 3+ was 61.3%.
Median duration of response was 11.8 months for all patients and 22.1 months for patients with IHC 3+ scores.
IHC 3+ expressing tumors had ORR rates ranging from 84.6% in endometrial cancers to zero in pancreatic cancer.
20 cases of interstitial lung disease reported, with one being fatal.

Цитати

"HER2 expression has been around a long time... represents an unmet need... this really exciting and represents a shift in how we think about cancer care." - Bradley Alexander McGregor, MD
"T-DXd is a potential new treatment option for patients with HER2-expressing solid tumors." - Kohei Shitara, MD

Ключові висновки, отримані з

T-DXd Active in Many Solid Tumors; 'Shift in Thinking'

by Neil Osterwe... о www.medscape.com 06-06-2023

https://www.medscape.com/viewarticle/992819

Глибші Запити

How might the potential tumor-agnostic development of T-DXd impact cancer treatment strategies

The potential tumor-agnostic development of T-DXd could have a significant impact on cancer treatment strategies by broadening the scope of targeted therapies available for patients with HER2-expressing solid tumors. By demonstrating efficacy across various tumor types beyond breast, gastroesophageal, and lung cancers, T-DXd opens up new possibilities for treating malignancies of the cervix, endometrium, ovaries, bladder, and potentially other sites. This shift in thinking towards a more inclusive approach to targeting HER2 expression in solid tumors could lead to personalized treatment options for patients who previously had limited choices. Additionally, the durable responses seen in the study suggest that T-DXd could become a valuable addition to the treatment armamentarium for advanced solid tumors expressing HER2, potentially improving outcomes and quality of life for these patients.

What challenges could arise in implementing routine HER2 testing for a broader range of patients

Implementing routine HER2 testing for a broader range of patients may pose several challenges in clinical practice. One key challenge is the lack of concordance between local and central assessment of HER2 immunohistochemistry (IHC) scores, as highlighted in the study. This discrepancy could lead to inconsistencies in identifying patients who would benefit from HER2-targeted therapies like T-DXd, emphasizing the need for quality assurance measures to ensure accurate characterization of HER2 status in solid tumors. Furthermore, the logistics of conducting HER2 testing on a larger scale across different tumor types and healthcare settings may require additional resources, expertise, and coordination among pathologists, oncologists, and other healthcare providers. Overcoming these challenges will be essential to effectively integrate routine HER2 testing into clinical practice and optimize the use of targeted therapies for patients with HER2-expressing solid tumors.

How can the findings of this study influence the development of targeted therapies for other types of solid tumors

The findings of this study have the potential to influence the development of targeted therapies for other types of solid tumors by demonstrating the efficacy of T-DXd in a broader range of advanced malignancies expressing HER2. The data showing clinically meaningful activity across various tumor types, including endometrial, ovarian, and bladder cancers, suggest that T-DXd could serve as a promising model for developing targeted therapies with tumor-agnostic activity. These results may inspire further research and clinical trials to explore the use of similar antibody-drug conjugates or HER2-targeted agents in different solid tumor types that exhibit HER2 expression. By expanding the understanding of HER2 as a therapeutic target beyond traditional indications like breast cancer, the study paves the way for innovative approaches to developing personalized treatments for diverse patient populations with HER2-expressing solid tumors.