DESTINY‑Gastric05 Phase 3 Trial of ENHERTU Initiated in Patients with Previously Untreated HER2 Positive Advanced Gastric Cancer
Immunotherapy is rapidly redefining the treatment landscape for gastric cancer, from metastatic to neoadjuvant, perioperative, and organ‑preserving settings.
**Background:** Ramucirumab plus paclitaxel is established for second-line advanced gastric cancer (AGC). Efficacy of ramucirumab with docetaxel had not been studied. **Methods:** 35 AGC patients refractory or intolerant to first-line therapy received ramucirumab 8 mg/kg (days 1 and 15) and docetaxel 60 mg/m² (day 1) every 28 days. Primary endpoint was overall response rate (ORR). **Results:** ORR 25.7 % (90 % CI 14.1–40.6), disease‑control rate 74.3 %. Median progression‑free survival 3.1 months, overall survival 11.5 months. Common grade ≥ 3 toxicities: neutropenia 69 %, leucopenia 57 %, febrile neutropenia 17 %, hypertension 14 %, anorexia 11 %. Peripheral sensory neuropathy occurred in 66 % (no grade ≥ 3). **Conclusions:** Ramucirumab‑docetaxel shows activity with acceptable safety and may reduce hospital visits due to biweekly dosing.
The shift to earlier, deeper and more selective checkpoint blockade promises not only palliation but personalization, precision and potential cure, especially for MSI‑H/MLH‑deficient tumors and frail patients excluded from standard trials.
Evidence level: Sejtvonalas. Laboratóriumi sejtekben vizsgálták.