Yelena Y. Janjigian, MD, Memorial Sloan Kettering Cancer Center, New York, NY, discusses the evolving landscape of treatment for HER2-positive metastatic gastric cancer. She emphasizes the significant progress made with antibody-drug conjugates (ADCs), drawing insights from their success in bladder cancer and other diseases. The Phase Ib/II DESTINY-Gastric03 (DG-03) trial (NCT04379596) employs trastuzumab deruxtecan, a HER2 ADC with a high drug-to-antibody ratio, in combination with anti-PD-1 therapy, initially using pembrolizumab. The study explores various bispecific antibodies, including combinations with CTLA-4 and PD-1 TIGIT. Additionally, the integration of capecitabine, a pivotal component in gastric cancer treatment, is being explored to enhance outcomes. The goal is to advance ADCs from later lines to first-line therapy, providing a comprehensive and improved approach for HER2-positive metastatic gastric cancer. This interview took place at the 2024 ASCO Gastrointestinal (GI) Cancers Symposium in San Francisco, CA.
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