Dr Yelena Janjigian speaks to ecancer about the evolving role of trastuzumab deruxtecan (T-DXd) in the treatment of HER2-positive gastric and gastroesophageal junction cancer, with a focus on its use in combination regimens for the first-line setting.

She talks about DESTINY-Gastric03 and DESTINY-Gastric05 trials that evaluate T-DXd in combination with anti–PD-1 therapy (pembrolizumab) and fluoropyrimidine-based chemotherapy for first-line treatment.

Dr Janjigian highlights that early-phase data suggest enhanced synergy between HER2-targeted antibody-drug conjugates and immunotherapy, potentially leading to deeper and more durable responses. A reduced dose of 5.4 mg/kg is being investigated to optimise tolerability while maintaining efficacy.