Trastuzumab Deruxtecan for -Mutant Metastatic Non–Small Cell Lung Cancer With or Without Brain Metastases

What is the effectiveness and safety of trastuzumab deruxtecan (T-DXd) 5.4-mg/kg and 6.4-mg/kg doses in patients with epidermal growth factor receptor 2 ( [formerly ])–mutant metastatic non–small cell lung cancer (NSCLC) with or without treated or untreated stable brain metastases?This secondary analysis included 243 participants in the DESTINY-Lung01 and DESTINY-Lung02 clinical trials. Patients with and without brain metastases who received the T-DXd 5.4-mg/kg dose had systemic confirmed objective response rates (ORRs) of 47% and 50%, respectively, and an intracranial confirmed ORR of 50%. With the T-DXd 6.4-mg/kg dose, systemic confirmed ORRs were 50% and 59% for patients with and without brain metastases, respectively, and the intracranial confirmed ORR was 30%.These findings support T-DXd use in patients with previously treated mutant metastatic NSCLC with or without brain metastases.

Corresponding Author: Pasi A. Jänne, MD, PhD, Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, 450 Brookline Ave, LC4114, Boston, MA 02215 (pasi_janne@dfci.harvard.edu).

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