DESTINY-Lung02
DESTINY-Lung02 confirmed that the antibody-drug conjugate trastuzumab deruxtecan shrinks about half of HER2-mutant lung cancers after chemotherapy and that the lower dose works as well with less lung inflammation.
Overview
DESTINY-Lung02 randomised 152 patients with metastatic HER2-mutant non-small-cell lung cancer that had progressed after platinum chemotherapy to trastuzumab deruxtecan at 5.4 mg/kg or 6.4 mg/kg every three weeks. DESTINY-Lung01 had shown a 55 percent response rate at 6.4 mg/kg but with interstitial lung disease in a quarter of patients.
The confirmed response rate was 49.0 percent at 5.4 mg/kg (102 patients) and 56.0 percent at 6.4 mg/kg (50 patients), with median durations of response of 16.8 and 5.9 months. Drug-related interstitial lung disease occurred in 12.9 percent at the lower dose and 28.0 percent at the higher dose.
The FDA had granted accelerated approval in August 2022 on the interim data, the first HER2-directed therapy for lung cancer, at the 5.4 mg/kg dose; DESTINY-Lung04 is testing the drug first line against chemotherapy plus pembrolizumab.
- 49 vs 56 out of 100 had their tumour shrink with Trastuzumab deruxtecan 5.4 mg/kg compared with Trastuzumab deruxtecan 6.4 mg/kg; 7 fewer per 100.
- On this measure the first group did worse, not better.
- A response rate counts how many people had their tumours shrink by a set amount; shrinking is encouraging but does not by itself show that people live longer or feel better.
- These results apply to the people the trial enrolled: Previously treated metastatic HER2 (ERBB2)-mutant non-small-cell lung cancer: trastuzumab deruxtecan 5.4 mg/kg versus 6.4 mg/kg. People in a different situation may not see the same effect.
- The trial selected people by a biomarker (HER2); the result should not be assumed for people whose cancer does not have it.
Numbers are from the trial as recorded here; see the source links in the table below. This is orientation, not medical advice: ask your team how closely the trial population matches you.
152 participants enrolled.
| Endpoint | Arm | n | Value | HR (95% CI) | p | Source |
|---|---|---|---|---|---|---|
| Confirmed objective response rateprimary | Trastuzumab deruxtecan 5.4 mg/kg | 102 | 49% | - | - | link |
| Trastuzumab deruxtecan 6.4 mg/kg | 50 | 56% |
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