Yasir Elamin, MD, an associate professor of thoracic medical oncology at The University of Texas MD Anderson Cancer Center, discusses results from the phase 3 DESTINY-Lung04 trial evaluating first-line trastuzumab deruxtecan (T-DXd) in metastatic HER2-mutated lung cancer. Dr. Elamin highlights the improvement in median progression-free survival from 8.3 months with chemotherapy plus immunotherapy to 14.3 months with T-DXd, the absence of an observed overall survival improvement amid a high crossover rate, and how the findings add to an expanding targeted treatment landscape that includes zongertinib and sevabertinib.
Transcript:
Dr. Elamin: My name is Yasir Elamin. I’m an associate professor of thoracic medical oncology at MD Anderson Cancer Center in Houston, Texas.
After DESTINY-Lung04, how should clinicians think about first-line treatment for HER2-mutated NSCLC?
Dr. Elamin: DESTINY-Lung04 was an important clinical trial that compared T-DXd, which is HER2 ADC, to standard-of-care chemotherapy in combination with immunotherapy. The trial included patients with metastatic HER2-mutated lung cancer, included patients with exon 19 or exon 20 mutations. It was a positive trial, improving the median progression-free survival from 8.3 months to 14.3 months. This is a clinically meaningful improvement.
Notably, the trial did not show an improvement in overall survival, very likely due to the high rate of crossover. I think that we, as clinicians, now have three drugs that are really potent targeted therapy for HER2-mutated lung cancer, namely zongertinib and sevabertinib. These two drugs are approved in the frontline setting by the U.S. FDA. T-DXd is approved in later lines.
So I think that the study of today takes us a step further towards precision medicine for a population that was a year ago difficult to treat, had no targeted therapy options.
