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A two-armed HER2 antibody beat Herceptin head-to-head as first-line treatment for HER2-positive stomach cancer, the first such win since 2010.
HERIZON-GEA-01, trial NCT05152147 sponsored by Jazz and BeOne and reported in 2026, showed that the two-armed HER2 antibody zanidatamab beats trastuzumab head to head as first-line treatment for HER2-positive advanced gastro-oesophageal adenocarcinoma, the first such win since ToGA in 2010. It randomised 914 patients to zanidatamab plus chemotherapy, with or without tislelizumab, or trastuzumab plus chemotherapy, met its primary progression-free survival endpoint in both zanidatamab arms and significantly improved overall survival, as published in the New England Journal of Medicine in 2026, with a supplemental licence application planned for the first half of 2026. It sets up zanidatamab as the HER2 agent of choice, and how trastuzumab deruxtecan fits after it 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.
920 enrolled.
| Endpoint | Arm | n | Value | HR (95% CI) | p | Source |
|---|---|---|---|---|---|---|
| Progression-free survivalprimary | Zanidatamab + chemotherapy + tislelizumab | - | 12.4 months | - | - | link |
| Zanidatamab + chemotherapy | - | 12.4 months | ||||
| Trastuzumab + chemotherapy | - | 8.1 months |
Shares HER2 sequence in gastric cancer: zanidatamab/trastuzumab + chemo ± PD-1 → T-DXd, HER2-positive gastric cancer, Trastuzumab, HER2.
Shares BeOne Medicines (formerly BeiGene), Tislelizumab, Oesophageal cancer, PD-1.
Shares HER2 sequence in gastric cancer: zanidatamab/trastuzumab + chemo ± PD-1 → T-DXd, HER2-positive gastric cancer, HER2, Oesophageal cancer.
Shares Jazz Pharmaceuticals, Zanidatamab, Bispecific antibodies, Oesophageal cancer.
Shares Jazz Pharmaceuticals, Zanidatamab, Bispecific antibodies, Trastuzumab.
Shares Jazz Pharmaceuticals, Zanidatamab, Bispecific antibodies, Trastuzumab.
Shares BeOne Medicines (formerly BeiGene), Tislelizumab, Oesophageal cancer, Gastric & gastro-oesophageal junction cancer.
Shares HER2-positive gastric cancer, HER2, Gastric & gastro-oesophageal junction cancer.