The treatment landscape for HER2-overexpressing non-small cell lung cancer (NSCLC) is evolving, particularly with the introduction of trastuzumab deruxtecan (T-DXd). Recent clinical trial data are influencing therapeutic strategies and decision-making. T-DXd is approved for HER2-positive (IHC 3+) solid tumors after prior systemic therapy and is included in the NCCN guidelines for IHC 3+ occult tumors.
Clinical Trial Data Updates with T-DXd
Data from the DESTINY-Lung01 (Cohort 1/1A) study, published in The Lancet in 2024, and the DESTINY-Lung03 trial, presented at WCLC 2024, are pivotal in understanding T-DXd's efficacy. The DESTINY-Lung01 trial showed promising results, which led to accelerated approval of T-DXd in HER2-mutant NSCLC. The DESTINY-Lung03 trial further explores the efficacy and safety profile of T-DXd in this patient population.
Incorporating T-DXd into Treatment Approaches
Experts are actively considering how to incorporate T-DXd into their treatment approach for patients with HER2-overexpressing NSCLC. The drug is being considered in various lines of therapy, including its use in HER2-mutant NSCLC. The emergence of HER2-targeted therapies, especially trastuzumab deruxtecan, has reshaped treatment approaches in HER2-overexpressing NSCLC, influencing biomarker interpretation and treatment decisions across different lines of therapy.
Biomarker Interpretation and Treatment Decision-Making
With the advent of targeted therapies and personalized medicine, the interpretation of biomarker testing, including IHC scoring and disease drivers, has shifted treatment decision-making. The evolving treatment landscape necessitates a nuanced understanding of HER2 overexpression and mutation status to optimize patient outcomes.
