Loading
The first randomised proof that a HER2 drug beats standard chemotherapy in second-line stomach cancer: Enhertu added about three months of life.
DESTINY-Gastric04, trial NCT04704934 sponsored by Daiichi Sankyo and AstraZeneca and reported at the ASCO 2025 plenary and in the New England Journal of Medicine, was the first randomised proof that a HER2 drug beats standard chemotherapy in second-line HER2-positive gastric cancer, with trastuzumab deruxtecan adding a few months of life. It randomised 494 patients after trastuzumab to trastuzumab deruxtecan or ramucirumab plus paclitaxel and met its primary overall survival endpoint, also improving progression-free survival, confirming the accelerated approvals from DESTINY-Gastric01 and DESTINY-Gastric02; interstitial lung disease requires monitoring. Where it sits after zanidatamab-based first-line therapy is the open question.
Numbers are from the trial as recorded here; see the source links in the table below. This is orientation, not medical advice: ask your team how closely the trial population matches you.
Shares Kohei Shitara, HER2-positive gastric cancer, Daiichi Sankyo, Trastuzumab deruxtecan.
Shares HER2-positive gastric cancer, Daiichi Sankyo, Trastuzumab deruxtecan, Topoisomerase-I inhibitors (and ADC payloads).
Shares HER2-positive gastric cancer, Daiichi Sankyo, Trastuzumab deruxtecan, Topoisomerase-I inhibitors (and ADC payloads).
Shares HER2 sequence in gastric cancer: zanidatamab/trastuzumab + chemo ± PD-1 → T-DXd, Kohei Shitara, HER2-positive gastric cancer, HER2.
Shares HER2-positive gastric cancer, Daiichi Sankyo, Trastuzumab deruxtecan, Topoisomerase-I inhibitors (and ADC payloads).
Shares HER2-positive gastric cancer, Daiichi Sankyo, Trastuzumab deruxtecan, Topoisomerase-I inhibitors (and ADC payloads).
Shares Interstitial lung disease (ILD) / pneumonitis, Daiichi Sankyo, Trastuzumab deruxtecan, Topoisomerase-I inhibitors (and ADC payloads).
Shares Ramucirumab, HER2-positive gastric cancer, Topoisomerase-I inhibitors (and ADC payloads), Gastric & gastro-oesophageal junction cancer.