Talking HER2-Targeted Therapy With Dr. Chau

Welcome to a very special series with OncLive! I’m your host today, Caroline Seymour.

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We had the pleasure of speaking with Ian Chau, MD, FRCP, consultant medical oncologist within the Gastrointestinal and Lymphoma units at The Royal Marsden Hospital, and Reader at the Institute of Cancer Research in London and Surrey, United Kingdom, who discussed the state of HER2-directed therapy in gastric/gastroesophageal cancer.

Approximately 20% to 22% of patients with gastric/GEJ cancer will have HER2-positive tumors, said Chau. As such, HER2 has become one of the guideline-recommended markers that should be tested for, preferably with a broad molecular panel, per the National Comprehensive Cancer Network, added Chau.

A patient with HER2-positive gastric/GEJ cancer should receive chemotherapy and trastuzumab. However, limited options exist for those who progress on these agents. However, antibody-drug conjugates, specifically trastuzumab deruxtecan, could help fill this unmet need, according to Chau. According to topline findings from the phase II DESTINY-Gastric01 trial, the HER2-targeted ADC showed a statistically significant improvement in objective response rate and overall survival versus physician’s choice of paclitaxel or irinotecan in patients with advanced HER2-positive gastric/GEJ cancer who progressed on 2 prior therapies, meeting the primary end point of the study. Additionally, the safety profile of the agent proved to be consistent with prior findings reported from the phase I study.

Data from the phase II study will be presented at an upcoming medical meeting. Also anticipated, are data from the phase II DESTINY-Gastric02 trial, in which patients with unresectable or metastatic HER2-positive gastric/GEJ cancer who progressed on or after a trastuzumab-based regimen will receive trastuzumab deruxtecan.

Listen on to hear Chau discuss HER2 testing in gastric/GEJ cancer and several HER2-targeted strategies under evaluation