Final analysis of DESTINY-Gastric02

In this video, Prof Dr Eric Van Cutsem discusses the final analysis of DESTINY-Gastric02, presented at ESMO GI 2026.¹ DESTINY-Gastric02 was a multicentre, open-label, single-arm phase II study conducted in Europe and the United States. It evaluated trastuzumab deruxtecan (T-DXd) in Western patients with HER2-positive unresectable or metastatic gastric or gastro-oesophageal junction adenocarcinoma who had progressed on or after first-line trastuzumab-containing therapy. HER2 positivity was centrally confirmed on a new biopsy after progression before treatment with T-DXd 6.4 mg/kg every 3 weeks. 

The final analysis, with longer follow-up, confirmed the efficacy observed in the earlier analyses and publication. Among 79 treated patients, the confirmed objective response rate by independent central review was 43.0%, including 4 complete responses and 30 partial responses. Median progression-free survival was 5.6 months and median overall survival was 12.1 months. The median duration of response was 8.3 months, which Prof Dr Van Cutsem highlights as longer than typically expected in the second-line treatment setting for gastric cancer. 

The safety profile was consistent with previous reports, and no new safety signals were observed with longer follow-up. Adjudicated drug-related interstitial lung disease/pneumonitis occurred in 13.9% of patients, mostly grade 1 or 2. Overall, these final results support single-agent T-DXd as an effective second-line treatment option for Western patients with HER2-positive advanced gastric or gastro-oesophageal junction cancer after progression on trastuzumab-based therapy.