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ASCO 2026 | Trastuzumab deruxtecan combinations in HER2+ upper gastrointestinal cancers
Yelena Janjigian, MD, Memorial Sloan Kettering Cancer Center, New York, NY, presents safety results from the DESTINY-Gastric03 trial (NCT04379596) of first-line trastuzumab deruxtecan-based combination regimens in patients with advanced HER2-positive gastric, gastroesophageal junction, or esophageal adenocarcinoma. Results across treatment arms demonstrated safety profiles generally consistent with the known profiles of each agent, with no new safety signals identified, supporting the continuation of the DESTINY-Gastric05 trial (NCT06731478). This interview took place during the 2026 American Society of Clinical Oncology (ASCO) Meeting in Chicago, IL.
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Transcript
At ASCO this year, we presented the Destiny Gastric 03 study, which is a phase two study looking at trastuzumab deruxtecan-based combinations in first-line setting in HER2-positive disease and the safety analysis from the low-dose and high-dose trastuzumab deruxtecan arms. And what we demonstrated is the combination of capecitabine plus trastuzumab deruxtecan at 5.4 mg per kg with pembrolizumab was safe and effective...
At ASCO this year, we presented the Destiny Gastric 03 study, which is a phase two study looking at trastuzumab deruxtecan-based combinations in first-line setting in HER2-positive disease and the safety analysis from the low-dose and high-dose trastuzumab deruxtecan arms. And what we demonstrated is the combination of capecitabine plus trastuzumab deruxtecan at 5.4 mg per kg with pembrolizumab was safe and effective. Why do we do this? Well, of course, antibody-drug conjugates revolutionized how we treat gastric cancer in later lines of therapy. Bringing it to first-line therapy is so important. But in order to do that, we have to combine them safely with fluoropyrimidine. And we were able to do that. The grade 3-4 toxicity rate was acceptable compared to what we would normally expect in this setting, in first-line setting. And now this regimen and the efficacy was very promising. We saw nearly 100 percent disease control rate. And so, and the response rate was excellent. So we’re moving this to a first-line setting in the combination DG05 study with this Destiny Gastric 05 study, which is a randomized phase three study. So hopefully we’ll be seeing the results soon.
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