Real-World Data of Trastuzumab Deruxtecan for Advanced Gastric Cancer: A Multi-Institutional Retrospective Study

• Published in: Journal of clinical medicine Vol. 11; no. 8; p. 2247
• Main Authors: Matsumoto, Toshihiko, Yamamura, Shogo, Ikoma, Tatsuki, Kurioka, Yusuke, Doi, Keitaro, Boku, Shogen, Shibata, Nobuhiro, Nagai, Hiroki, Shimada, Takanobu, Tsuduki, Takao, Tsumura, Takehiko, Takatani, Masahiro, Yasui, Hisateru, Satake, Hironaga
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 17-04-2022; MDPI
• Subjects: Ascites; Cancer therapies; Chemotherapy; Clinical medicine; Gastric cancer; Heart failure; Medical prognosis; Metastasis; Monoclonal antibodies; Patients; Response rates; Statistical analysis; Targeted cancer therapy; United States > US; T-DXd; real-world data; gastric cancer; trastuzumab deruxtecan; chemotherapy
• ISSN: 2077-0383; 2077-0383
• DOI: 10.3390/jcm11082247

Trastuzumab deruxtecan (T-DXd) has shown promising efficacy against
positive advanced gastric cancer (AGC). However, data on its real-world efficacy in AGC patients are insufficient, and the predictive marker of T-DXd is unclear. In this multi-center retrospective study, we collected clinical information of 18 patients with
-positive AGC who received T-DXd after intolerant or refractory responses to at least two prior regimens and analyzed predictive factors. The median age was 71 years (range: 51-85), 13 men were included, and ECOG performance status (PS): 0/1/2/3 was 9/6/2/1. A total of 11 patients (61%) received prior immune checkpoint inhibitors (ICIs), 14 patients were
3+, and 4 patients were
2+/FISH positive. The median trastuzumab (Tmab)-free interval was 7.7 months (range: 2.8-28.6). The overall response rate was 41%, and the disease control rate was 76%. Median progression-free survival (PFS) was 3.9 months (95% CI: 2.6-6.5), and median overall survival (OS) was 6.1 months (95% CI: 3.7-9.4). PFS (6.5 vs. 2.9 months,
= 0.0292) and OS (9.2 vs. 3.7 months,
= 0.0819) were longer in patients who received prior ICIs than in those who had not. PFS (6.5 vs. 3.4 months,
= 0.0249) and OS (9.4 vs. 5.7 months,
= 0.0426) were longer in patients with an 8 month or longer Tmab-free interval. In patients with ascites, PFS (6.5 vs. 2.75 months,
= 0.0139) and OS (9.4 vs. 3.9 months,
= 0.0460) were shorter. T-DXd showed promising efficacy in
-positive AGC patients in a real-world setting. Pre-administration of ICIs and a sufficient Tmab-free interval may be predictive factors of T-DXd efficacy.