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Trastuzumab Deruxtecan in HER2 -Mutant Non–Small-Cell Lung Cancer

Open access
Li, Bob T., Smit, Egbert F., Goto, Yasushi, Nakagawa, Kazuhiko, Udagawa, Hibiki, Mazières, Julien, Nagasaka, Misako, Bazhenova, Lyudmila, Saltos, Andreas N., Felip, Enriqueta, Pacheco, Jose M., Pérol, Maurice, Paz-Ares, Luis, Saxena, Kapil, Shiga, Ryota, Cheng, Yingkai, Acharyya, Suddhasatta, Vitazka, Patrik, Shahidi, Javad, Planchard, David, Jänne, Pasi A.·2022·New England Journal of Medicine

Abstract

BACKGROUNDHuman epidermal growth factor receptor 2 (HER2)-targeted therapies have not been approved for patients with non-small-cell lung cancer (NSCLC).The efficacy and safety of trastuzumab deruxtecan (formerly DS-8201), a HER2 antibody-drug conjugate, in patients with HER2-mutant NSCLC have not been investigated extensively. METHODSWe conducted a multicenter, international, phase 2 study in which trastuzumab deruxtecan (6.4 mg per kilogram of body weight) was administered to patients who had metastatic HER2-mutant NSCLC that was refractory to standard treatment.The primary outcome was objective response as assessed by independent central review.Secondary outcomes included the duration of response, progression-free survival, overall survival, and safety.Biomarkers of HER2 alterations were assessed. RESULTSA total of 91 patients were enrolled.The median duration of follow-up was 13.1 months (range, 0.7 to 29.1).Centrally confirmed objective response occurred in 55% of the patients (95% confidence interval [CI], 44 to 65).The median duration of response was 9.3 months (95% CI, 5.7 to 14.7).Median progression-free survival was 8.2 months (95% CI, 6.0 to 11.9), and median overall survival was 17.8 months (95% CI, 13.8 to 22.1).The safety profile was generally consistent with those from previous studies; grade 3 or higher drug-related adverse events occurred in 46% of patients, the most common event being neutropenia (in 19%).Adjudicated drugrelated interstitial lung disease occurred in 26% of patients and resulted in death in 2 patients.Responses were observed across different HER2 mutation subtypes, as well as in patients with no detectable HER2 expression or HER2 amplification. CONCLUSIONSTrastuzumab deruxtecan showed durable anticancer activity in patients with previously treated HER2-mutant NSCLC.The safety profile included interstitial lung disease that was fatal in two cases.Observed toxic effects were generally consistent with those in previously reported studies.(Funded by Daiichi Sankyo and AstraZeneca; DESTINY-Lung01 ClinicalTrials.govnumber, NCT03505710.

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Metadata

Authors
Li, B. T., Smit, E. F., Goto, Y., Nakagawa, K., Udagawa, H., Mazières, J., Nagasaka, M., Bazhenova, L., Saltos, A. N., Felip, E., Pacheco, J. M., Pérol, M., Paz-Ares, L., Saxena, K., Shiga, R., Cheng, Y., Acharyya, S., Vitazka, P., Shahidi, J., Planchard, D., & Jänne, P. A.
Venue
New England Journal of Medicine
Published
2022-01-20
Volume
386
Issue
3
Pages
241-251
ISSN
  • 0028-4793 (ISSN-L)
  • 1533-4406
OpenAlex
W3201219318
Cited by
1,021
References
38
FWCI
87.23
Type
journal article
Language
en
Open access
bronze

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CoChat. (2026). Citation check: Trastuzumab Deruxtecan in HER2 -Mutant Non–Small-Cell Lung Cancer. https://app.cochat.ai/papers/10.1056/nejmoa2112431
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Li, B. T., Smit, E. F., Goto, Y., Nakagawa, K., Udagawa, H., Mazières, J., Nagasaka, M., Bazhenova, L., Saltos, A. N., Felip, E., Pacheco, J. M., Pérol, M., Paz-Ares, L., Saxena, K., Shiga, R., Cheng, Y., Acharyya, S., Vitazka, P., Shahidi, J., . . . Jänne, P. A. (2022). Trastuzumab Deruxtecan in HER2 -Mutant Non–Small-Cell Lung Cancer. New England Journal of Medicine. https://doi.org/10.1056/nejmoa2112431

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Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).

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