Geoffrey Ku, MD, Memorial Sloan Kettering Cancer Center, New York, NY, discusses practical considerations surrounding the use of molecular testing in patients with HER2-positive (HER2+) gastric cancer. In the DESTINY-Gastric02 trial (NCT04014075), patients with gastric cancer who had progressed on trastuzumab had to undergo a biopsy to confirm continued HER2+ status before they could receive trastuzumab deruxtecan (T-DXd). The rationale of this being that a HER2-targeted therapy would be ineffective in patients who were no longer HER2+. However, in the DESTINY-Gastric01 trial (NCT03329690), patients were not required to undergo a biopsy after progression on trastuzumab. The overall clinical outcomes of the two trials were similar, raising the question of whether the biopsy is necessary. Dr Ku also discusses the use of ctDNA for situations where a biopsy cannot be performed. This interview took place at the European Society for Medical Oncology (ESMO) 2022 Congress in Paris, France.
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