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For HER2-positive stomach cancer, an antibody-plus-chemotherapy first, then Enhertu when it progresses. Both steps now have phase 3 proof.
First line: trastuzumab + chemotherapy + pembrolizumab (KEYNOTE-811, PD-L1 CPS ≥1) or zanidatamab + chemotherapy ± tislelizumab (HERIZON-GEA-01, PFS 12.4 vs 8.1 months). Second line: T-DXd (DESTINY-Gastric04, OS 14.7 vs 11.4 months). HER2 loss after first-line therapy occurs in ~30%, so re-biopsy or ctDNA before T-DXd is advisable.
Shares HER2-positive gastric cancer, Trastuzumab deruxtecan, Trastuzumab, Gastric & gastro-oesophageal junction cancer.
Shares ToGA, HER2-positive gastric cancer, Trastuzumab, HER2.
Shares ToGA, Trastuzumab, HER2, Gastric & gastro-oesophageal junction cancer.
Shares HER2-positive gastric cancer, Trastuzumab deruxtecan, Trastuzumab, Gastric & gastro-oesophageal junction cancer.
Shares ToGA, DESTINY-Gastric04, Trastuzumab deruxtecan, HER2.
Shares HER2-positive gastric cancer, HER2, Gastric & gastro-oesophageal junction cancer.
Shares Zanidatamab, Trastuzumab deruxtecan, HER2, Gastric & gastro-oesophageal junction cancer.
Shares HER2-positive gastric cancer, Trastuzumab deruxtecan, Trastuzumab, Gastric & gastro-oesophageal junction cancer.