Division of Medical Oncology, The Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan.
Department of Endoscopy and Gastrointestinal Oncology, National Cancer Center Hospital East, Chiba, Japan.
Jpn J Clin Oncol. 2024 Apr 6;54(4):434-443. doi: 10.1093/jjco/hyad181.
HER2-expressing salivary gland carcinoma (SGC) is associated with poor prognosis. Trastuzumab deruxtecan (T-DXd, DS-8201) has shown evidence of antitumor activity for several HER2-expressing solid tumors in multiple studies. This study aimed to present the efficacy and safety of T-DXd in patients with HER2-expressing SGC from a pooled analysis.
Patients with HER2-expressing SGC were pooled from two phase I, open-label studies of T-DXd: a two-phase, multiple-dose, first-in-human study (NCT02564900) and a single-sequence crossover drug-drug interaction study (NCT03383692). Endpoints included efficacy (objective response rate [ORR], duration of response [DoR] and progression-free survival [PFS]) and safety.
This pooled analysis included 17 patients with SGC (median age: 57 years; male: 88.2%); median (range) follow-up duration was 12.0 (2.3-34.8) months. Among these patients, 14 had received prior HER2-targeted agents and 13 had undergone prior radiotherapy. The investigator-assessed confirmed ORR was 58.8% (95% confidence interval [CI], 32.9-81.6). The median (95% CI) DoR and PFS were 17.6 months (4.0 to not evaluable [NE]) and 20.5 months (11.1-NE), respectively. All 17 patients reported treatment-emergent adverse events (TEAEs); 76.5% reported TEAEs of grade ≥3. The most common TEAEs were decreased appetite (94.1%), nausea (88.2%) and neutrophil count decreased (76.5%). Of the 17 patients, five (29.4%) reported adjudicated drug-related interstitial lung disease (grade 1, n = 3; grade 2, n =1; grade 3, n = 1).
The results of this pooled analysis provide evidence that clinical benefit is achievable with T-DXd in patients with HER2-expressing SGC.
FIH study, NCT02564900; DDI study, NCT03383692.
HER2 表达的唾液腺癌(SGC)与预后不良相关。曲妥珠单抗deruxtecan(T-DXd,DS-8201)在多项研究中显示出对多种 HER2 表达的实体瘤具有抗肿瘤活性。本研究旨在汇总分析中报告 T-DXd 在 HER2 表达的 SGC 患者中的疗效和安全性。
从 T-DXd 的两项 I 期、开放标签研究中对 HER2 表达的 SGC 患者进行了汇总分析:一项两阶段、多剂量、首次人体研究(NCT02564900)和一项单序列交叉药物相互作用研究(NCT03383692)。终点包括疗效(客观缓解率[ORR]、缓解持续时间[DoR]和无进展生存期[PFS])和安全性。
该汇总分析纳入了 17 例 SGC 患者(中位年龄:57 岁;男性:88.2%);中位(范围)随访时间为 12.0(2.3-34.8)个月。这些患者中,14 例曾接受过 HER2 靶向治疗,13 例曾接受过放疗。研究者评估的确认 ORR 为 58.8%(95%置信区间[CI],32.9-81.6)。中位(95%CI)DoR 和 PFS 分别为 17.6 个月(4.0 至不可评估[NE])和 20.5 个月(11.1-NE)。所有 17 例患者均报告了治疗相关的不良事件(TEAEs);76.5%的患者报告了≥3 级的 TEAEs。最常见的 TEAEs 为食欲下降(94.1%)、恶心(88.2%)和中性粒细胞计数下降(76.5%)。在 17 例患者中,5 例(29.4%)患者报告了药物相关的间质性肺病(1 级,n=3;2 级,n=1;3 级,n=1),经裁决确定。
本汇总分析结果表明,T-DXd 在 HER2 表达的 SGC 患者中具有临床获益。
FIH 研究,NCT02564900;DDI 研究,NCT03383692。