A trial of trastuzumab deruxtecan for cancers that have a large amount of HER2 (DESTINY-PanTumour02)

Cancer type:

Bile duct cancer
Biliary tree cancers
Bladder cancer
Cervical cancer
Gallbladder cancer
Ovarian cancer
Pancreatic cancer
Secondary cancers
Womb (uterine or endometrial) cancer

Status:

Results

Phase:

Phase 2

This trial was looking at trastuzumab deruxtecan for cancers that had a high number of HER2 Open a glossary item receptors. 

The trial was open for people to join between 2020 and 2022. The team published some results in 2023.

More about this trial

Doctors use a test called an immunohistochemistry (IHC) test to look for HER2 receptors on cancer cells. Results can be 0, 1+, 2+ or 3+. Cancers that have an IHC result of 3+ are called HER2 positive. 

When this trial was done, doctors in the UK could use trastuzumab deruxtecan for HER2 Open a glossary item positive breast cancer that has spread to other parts of the body. This is called secondary breast cancer

In this trial, researchers looked at whether doctors could use trastuzumab deruxtecan to treat other solid tumours Open a glossary item with different amounts of HER2 receptors.

Everyone taking part in this trial had already had treatment. Their cancer was either locally advanced Open a glossary item, had spread (metastatic Open a glossary item), or they couldn’t have surgery (unresectable).

People taking part had one of several different cancers, including:

This was a phase 2 trial. People taking part had trastuzumab deruxtecan once every 3 weeks.

The main aims of the trial were to find out:

  • how well trastuzumab deruxtecan works for people with different amounts of HER2 
  • more about the side effects

Summary of results

This trial showed that trastuzumab deruxtecan may help to treat other HER2 positive cancers. This was for people who already had treatment for their cancer.

Results
A total of 267 people took part in this trial. All of them had at least one dose of trastuzumab deruxtecan. 

The researchers also looked at the median Open a glossary item number of treatment cycles Open a glossary item. They found that this was 8 for everyone taking part.

The researchers were able to analyse the results for most people who took part in 2023. 

They looked at the number of people whose cancer:

  • got smaller (partial response)
  • was not visible on a scan (complete response)

They found it was 99 out of 267 people (37%) in total.
 
When the team looked at the results in more detail, they found it was:

  • 46 out of 75 people (61%) for those with IHC3+ cancer
  • 53 out of 192 people (28%)for those who had IHC 0, 1 or 2+ cancer 

The researchers looked at how long it was before people's cancer started to grow again in half the people taking part. They call this median progression free survival. They found it was:

  • shortest in people with pancreatic cancer (around 3 months)
  • longest in people with endometrial cancer (around 11 months)

It was longer in people with IHC3+ cancers (almost 12 months) when they compared all the IHC groups.

They also looked at the time until half the people were living. They call this median overall survival. They found it was:

  • more than 13 months for everyone taking part
  • shortest in people with pancreatic cancer (5 months)
  • longest in people with endometrial cancer (26 months)

This was also longer in people with IHC3+ cancers (around 21 months) when they compared all the IHC groups.

Side effects
226 out of the 267 people (85%) taking part in the trial had at least one side effect. Most side effects were mild and didn’t last long.

The most common side effects were:

  • feeling or being sick
  • a drop in red blood cells causing shortness of breath and tiredness
  • diarrhoea
  • extreme tiredness (fatigue)

109 people (41%) had more severe side effects.

The most common of the severe side effects were:

  • a drop in white blood cells causing and increased risk of infection
  • a drop in red blood cells causing shortness of breath and tiredness

23 people stopped treatment early because of side effects. 

Four people died of infection and inflammation. 

We have more information about the side effects of trastuzumab deruxtecan in our Cancer drugs section.

Conclusion
The trial team concluded that trastuzumab deruxtecan may help to treat other cancers that have a high number of HER2 receptors. 

The treatment worked best in cancers that were IHC3+. This is in people who’ve already had treatment for their cancer.

More detailed information
There is more information about this research in the reference below. 

Please note, the information we link to here is not in plain English. It has been written for healthcare professionals and researchers.

Efficacy and Safety of Trastuzumab Deruxtecan in Patients With HER2-Expressing Solid Tumors: Primary Results From the DESTINY-PanTumor02 Phase II Trial
F Meric-Bernstam and others
Journal of Clinical Oncology, 2023. Volume 42, Pages 47-58.

Where this information comes from    
We have based this summary on the information in the article above. This has been reviewed by independent specialists (peer reviewed Open a glossary item) and published in a medical journal. We have not analysed the data ourselves. As far as we are aware, the link we list above is active and the article is free and available to view.

Recruitment start:

Recruitment end:

How to join a clinical trial

Please note: In order to join a trial you will need to discuss it with your doctor, unless otherwise specified.

Please note - unless we state otherwise in the summary, you need to talk to your doctor about joining a trial.

Chief Investigator

Dr Banerjee

Supported by

AstraZeneca

If you have questions about the trial please contact our cancer information nurses

Freephone 0808 800 4040

Last review date

CRUK internal database number:

17726

Please note - unless we state otherwise in the summary, you need to talk to your doctor about joining a trial.

Last reviewed:

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