{"entity":{"id":"paper-destiny-gastric01-nejm-2020","kind":"paper","name":"DESTINY-Gastric01: trastuzumab deruxtecan in previously treated HER2-positive gastric cancer","aka":[],"tldr":"Trastuzumab deruxtecan shrank tumours in half of patients with HER2-positive gastric cancer that had progressed after trastuzumab, compared with 14 percent on chemotherapy, and lengthened survival by over four months.","summary":"Randomised phase 2 trial in Japan and South Korea of 187 patients with HER2-positive advanced gastric or junctional adenocarcinoma after at least two prior regimens including trastuzumab, randomised 2:1 to trastuzumab deruxtecan 6.4 mg/kg or physician's choice of irinotecan or paclitaxel.\n\nObjective response was 51 versus 14 percent and median overall survival 12.5 versus 8.4 months (hazard ratio 0.59); interstitial lung disease occurred in 10 percent, with myelosuppression as the other main toxicity.","asOf":"2026-09-17","links":[{"label":"N Engl J Med 2020","url":"https://doi.org/10.1056/NEJMoa2004413"},{"label":"PubMed","url":"https://pubmed.ncbi.nlm.nih.gov/32469182/"}],"tags":[],"related":[],"cancers":["gastric-her2-positive"],"sections":[],"technologies":[],"targets":[],"drugs":["trastuzumab","trastuzumab-deruxtecan"],"companies":[],"institutions":[],"pathways":[],"terms":[],"trials":["destiny-gastric01","destiny-gastric02"],"people":[],"bottlenecks":[],"keyPapers":[],"journals":["nejm"],"dependsOn":[],"notes":[],"journal":"New England Journal of Medicine","year":2020,"doi":"10.1056/NEJMoa2004413","pmid":"32469182","authors":"Shitara K, Bang YJ, Iwasa S, et al.","paperType":"rct","findings":["Objective response 51 percent vs 14 percent.","Median overall survival 12.5 vs 8.4 months; hazard ratio 0.59."],"whatItMeans":"Trastuzumab deruxtecan is the standard second- or third-line treatment for HER2-positive gastric cancer, later confirmed against ramucirumab-paclitaxel in DESTINY-Gastric04.","caveats":["Asian population; the Western DESTINY-Gastric02 study showed a lower response rate.","Interstitial lung disease requires monitoring."],"changedPractice":true,"participants":187},"route":"/key-papers/paper-destiny-gastric01-nejm-2020/","neighbours":{"cancer":[{"id":"gastric-her2-positive","kind":"cancer","name":"HER2-positive gastric cancer","route":"/cancers/gastric-her2-positive/"}],"drug":[{"id":"trastuzumab","kind":"drug","name":"Trastuzumab","route":"/drugs/trastuzumab/"},{"id":"trastuzumab-deruxtecan","kind":"drug","name":"Trastuzumab deruxtecan","route":"/drugs/trastuzumab-deruxtecan/"}],"trial":[{"id":"destiny-gastric01","kind":"trial","name":"DESTINY-Gastric01","route":"/trials/destiny-gastric01/"},{"id":"destiny-gastric02","kind":"trial","name":"DESTINY-Gastric02","route":"/trials/destiny-gastric02/"}],"journal":[{"id":"nejm","kind":"journal","name":"New England Journal of Medicine","route":"/journals/nejm/"}]}}