T-DXd Could Be 'Practice-Changing' in HER2-Expressing Gynecologic Cancers

— Impressive response rates in patients with the highest levels of HER2 expression

MedicalToday

In heavily pretreated patients with HER2-expressing gynecologic cancers, the antibody-drug conjugate trastuzumab deruxtecan (T-DXd; Enhertu) produced very encouraging response rates, according to findings presented at the annual meeting of the International Gynecologic Cancer Society.

Ritu Salani, MD, of the University of California Los Angeles, discusses the results from the DESTINY-PanTumor02 trial and why she considers them practice-changing.

Following is a transcript of her remarks:

The other thing that's on the horizon was there was the role of HER2 ADC or antibody-drug conjugate, which is trastuzumab deruxtecan, which really made an impact in breast cancer. And we saw a trial of pan tumor testing, which really focused on gynecologic cancers. So cervix cancer, ovarian cancer, and endometrial cancer were studied with this. And they looked at IHC [immunohistochemistry] expression, really looking at patients with all-comers, but really highlighting the IHC 3+ and 2+.

And the response rates -- these were mostly heavily pretreated patients -- and the response rates are really very impressive. Small study. We need to understand what these patients received previously, how standard these patients were, but in the HER2 expression-positive patients, whether it was IHC 2 or 3, we saw response rates in these heavily pretreated patients that we've not seen before.

So I think this is something that's really exciting. It's definitely on the cusp of changing practice. It's already changed practice in other areas, and I think it's only a matter of time before it does in gynecologic malignancies. It's kind of across the panel, and I'm hoping that this will receive disease site-agnostic or kind of biomarker approval for this agent as we learn more about it.

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