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4

Indication details

Control Arm
ChT (irinitecan or paclitaxel)
Therapeutic Indication
Treatment of adult patients with advanced HER2-positive gastric or gastroesophageal junction adenocarcinoma in patients who have received a prior trastuzumab-based regimen
Tumour Type
Gastrointestinal Cancers
Tumour Sub-type
Gastric or gastroesophageal junction adenocarcinoma
Tumour Stage
Advanced
Tumour Sub-Group
HER2+
Trial Name
DESTINY-Gastric01
NCT Number
NCT03329690
Trial Phase
Phase II

Approval details

FDA Approval
FDA approval January 2021
EMA Approval
EMA (CHMP) November 2022 EC decision January 2023
Comment
EMA approval is based on DESTINY-Gastric01 and DESTINY-Gastric02 - EMA therapeutic setting: treatment of adult patients with advanced HER2-positive gastric or gastroesophageal junction adenocarcinoma in patients who have received a prior trastuzumab-based regimen

Primary Outcome(s)

Primary Outcome(s)
ORR, hierarchically: OS
Evaluated Outcome
OS
Form(s)
Form 2a

Outcome Data

OS Control
8.4 months
OS Gain
4.1 months
OS HR
0.59 (0.39-0.88)
ORR
37%

Adjustments

QoL Comment
QoL was not a prespecified endpoint

Final Score (after adjustments)

Preliminary non-curative score

4

Final non-curative score

4

Scorecard details

ESMO-MCBS version
ESMO-MCBS v1.1
Scorecard ID
243
Scorecard version
1
Issue date
01.03.2021
Last update
28.11.2023
Trastuzumab deruxtecan DESTINY-Gastric01

PRELIMINARY SCORE

OS

ADJUSTMENTS

Trastuzumab deruxtecan DESTINY-Gastric01

FINAL SCORE

Overall Survival / Disease-Free Survival / Pathological Complete Response
4
Overall Survival
Progression-Free Survival
Non-inferiority (Improved Quality of Life or Reduced Adverse Events) / Response Rate
Overall Response Rate / Duration of Response
Gastrointestinal Cancers
Treatment of adult patients with advanced HER2-positive gastric or gastroesophageal junction adenocarcinoma in patients who have received a prior trastuzumab-based regimen
Trastuzumab deruxtecan
ChT (irinitecan or paclitaxel)

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    Legend

    Information about symbols, abbrevations and color codes

    Red = negative
    Green = positive
    Grey = neutral
    ? Grey + ? = neutral with pending data
    DFS
    Disease-Free Survival
    DoR
    Duration of Response
    EFS
    Event-Free Survival
    HR
    Hazard Ratio
    NEB
    No evaluable benefit
    NI
    Non-inferiority Study
    ORR
    Overall Response Rate
    OS
    Overall Surival
    pCR
    Pathological Complete Response/Remission
    PFS
    Progression-Free Survival
    QoL
    Quality of Life
    RFS
    Relapse-Free Survival
    RR
    Response Rate

    QoL adjustments

    Other adjustments*

    Serious and disabling adverse effects

    Red = negative / deterioration

    Green = positive / improvement

    QoL adjustments

    Red = negative / deterioration

    Green = positive / improvement

    Other adjustments*

    Red = negative / deterioration

    Green = positive / improvement

    Serious and disabling adverse effects

    Red = negative / deterioration

    Green = positive / improvement

    * Other adjustments include:

    - Long-term plateau in the survival curve
    - Long-term plateau in the PFS curve
    - Early stopping or crossover
    - Only improved PFS mature data shows no OS advantage and no improved Qol.

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