# DESTINY-Lung02: two doses of trastuzumab deruxtecan in HER2-mutant metastatic non-small-cell lung cancer

Source: https://onco.cc/key-papers/paper-destiny-lung02-goto-jco-2023/  
OnCo record `paper-destiny-lung02-goto-jco-2023` (Key paper). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Comparing two doses of trastuzumab deruxtecan in HER2-mutant lung cancer showed that the lower 5.4 mg/kg dose gave the same response rate of about half with far less lung toxicity, fixing the approved dose.

## Summary

Randomised phase 2 trial of 152 patients with previously treated HER2-mutant metastatic non-small-cell lung cancer randomised 2:1 to trastuzumab deruxtecan 5.4 or 6.4 mg/kg.

Objective response was 49.0 percent at 5.4 mg/kg and 56.0 percent at 6.4 mg/kg, with median durations of 16.8 and 5.9 months; adjudicated interstitial lung disease was 12.9 versus 28.0 percent.

## Fields

- Kind: Key paper
- Last checked: 2026-09-17
- Journal: Journal of Clinical Oncology
- Year: 2023
- DOI: 10.1200/JCO.23.01361
- Authors: Goto K, Goto Y, Kubo T, et al.
- Findings: Objective response 49.0 percent (5.4 mg/kg) vs 56.0 percent (6.4 mg/kg).; Interstitial lung disease 12.9 percent vs 28.0 percent.
- What it means: Trastuzumab deruxtecan 5.4 mg/kg is the approved regimen for HER2-mutant lung cancer after platinum chemotherapy, and the trial is a rare example of dose optimisation improving safety without losing efficacy.
- Caveats: Not powered to compare efficacy between doses formally.

## Sources

- J Clin Oncol 2023: https://doi.org/10.1200/JCO.23.01361
- PubMed: https://pubmed.ncbi.nlm.nih.gov/37694347/

## Connected records

- cancers: [HER2-mutant non-small-cell lung cancer](https://onco.cc/cancers/her2-mutant-nsclc/)
- drugs: [Trastuzumab](https://onco.cc/drugs/trastuzumab/), [Trastuzumab deruxtecan](https://onco.cc/drugs/trastuzumab-deruxtecan/)
- trials: [DESTINY-Lung02](https://onco.cc/trials/destiny-lung02/)
- journals: [Journal of Clinical Oncology](https://onco.cc/journals/jco/)

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