DESTINY-Lung02: two doses of trastuzumab deruxtecan in HER2-mutant metastatic non-small-cell lung cancer
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.
Overview
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.
- 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.
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.
- Not powered to compare efficacy between doses formally.
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