KOL Views: AstraZeneca, Daiichi Sankyo’s Enhertu is shaking up breast cancer – is gastric cancer next?

Enhertu (trastuzumab deruxtecan) was just launched after an early approval from the FDA in third-line HER2-positive breast cancer but partners AstraZeneca and Daiichi Sankyo are already eyeing a label expansion in gastric cancer – an indication that has eluded competing HER2-targeting drugs – after last month’s encouraging top-line readout in the pivotal Phase II DESTINY-Gastric01 trial.

To provide FirstWord readers with rapid feedback on initial use of Enhertu in breast cancer and its prospects in gastric cancer, we are hosting an expert call with a key opinion leader (KOL) early next week.

Key topics that will be discussed during the call include, among other things… how quickly is Enhertu being adopted as third-line therapy; how does Enhertu’s risk/benefit profile look relative to other HER2-targeting agents, and in particular how much of a concern is the risk of interstitial lung disease; how early in the treatment paradigm do you think Enhertu will eventually move and is first-line a possibility; were you at all surprised by Enhertu’s success in improving overall response rate (ORR) and overall survival (OS) in the pivotal Phase II DESTINY-Gastric01 trial; Enhertu achieved an ORR of 43% in a Phase I trial but when detailed DESTINY-Gastric01 data are available could you benchmark what level of efficacy on response rate and/or survival you would consider impressive, middle of the road and disappointing; given differences in available therapies, is Enhertu’s risk/benefit profile likely to be more or less attractive in gastric cancer relative to breast cancer; is Enhertu’s tolerability, particularly the risk of potentially fatal interstitial lung disease, any more or less concerning and/or manageable in gastric cancer; DESTINY-Gastric01 was conducted in Asia but do you expect that Enhertu will be approved for gastric cancer in the US; how early in the treatment paradigm could Enhertu eventually move; are you more optimistic about the prospects for Enhertu or Roche’s Perjeta (pertuzumab), which is in Phase III testing in front-line and neoadjuvant HER2-positive gastro-oesophageal adenocarcinoma; and are you more or less optimistic about use of Enhertu in lung cancer relative to breast and gastric cancer?

Ask the expert!

Furthermore, we invite FirstWord Pharma readers to submit their own questions for consideration. Please click here to do so. We can't guarantee that all questions submitted will be asked due to time constraints, but we will do our utmost to cover the important issues relating to the evolving landscape for Enhertu and other HER2-targeting cancer drugs.

We endeavour to provide feedback from KOLs as quickly as possible. Interview content will be published for FirstWord Pharma PLUS subscribers to read. To be notified when the interview content is available please click here.

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As always, FirstWord would very much like to receive your feedback and suggestions.

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