Trastuzumab deruxtecan in patients with human epidermal growth factor receptor 2-expressing salivary gland carcinoma: a pooled analysis of two phase I studies

Jpn J Clin Oncol. 2024 Apr 6;54(4):434-443. doi: 10.1093/jjco/hyad181.

Abstract

Background: HER2-expressing salivary gland carcinoma (SGC) is associated with poor prognosis. Trastuzumab deruxtecan (T-DXd, DS-8201) has shown evidence of antitumor activity for several HER2-expressing solid tumors in multiple studies. This study aimed to present the efficacy and safety of T-DXd in patients with HER2-expressing SGC from a pooled analysis.

Methods: Patients with HER2-expressing SGC were pooled from two phase I, open-label studies of T-DXd: a two-phase, multiple-dose, first-in-human study (NCT02564900) and a single-sequence crossover drug-drug interaction study (NCT03383692). Endpoints included efficacy (objective response rate [ORR], duration of response [DoR] and progression-free survival [PFS]) and safety.

Results: This pooled analysis included 17 patients with SGC (median age: 57 years; male: 88.2%); median (range) follow-up duration was 12.0 (2.3-‍34.8) months. Among these patients, 14 had received prior HER2-targeted agents and 13 had undergone prior radiotherapy. The investigator-assessed confirmed ORR was 58.8% (95% confidence interval [CI], 32.9-‍81.6). The median (95% CI) DoR and PFS were 17.6 months (4.0 to not evaluable [NE]) and 20.5 months (11.1-NE), respectively. All 17 patients reported treatment-emergent adverse events (TEAEs); 76.5% reported TEAEs of grade ≥3. The most common TEAEs were decreased appetite (94.1%), nausea (88.2%) and neutrophil count decreased (76.5%). Of the 17 patients, five (29.4%) reported adjudicated drug-related interstitial lung disease (grade 1, n = 3; grade 2, n =1; grade 3, n = 1).

Conclusion: The results of this pooled analysis provide evidence that clinical benefit is achievable with T-DXd in patients with HER2-expressing SGC.

Clinical trial information: FIH study, NCT02564900; DDI study, NCT03383692.

Keywords: DS8201-A-A104; DS8201-A-J101; human epidermal growth factor receptor 2; salivary gland carcinoma; trastuzumab deruxtecan.

Publication types

  • Meta-Analysis

MeSH terms

  • Antibodies, Monoclonal, Humanized / adverse effects
  • Antibodies, Monoclonal, Humanized / therapeutic use
  • Camptothecin* / analogs & derivatives
  • Camptothecin* / therapeutic use
  • Carcinoma* / drug therapy
  • Female
  • Humans
  • Immunoconjugates* / adverse effects
  • Immunoconjugates* / therapeutic use
  • Male
  • Middle Aged
  • Receptor, ErbB-2 / metabolism
  • Salivary Glands / metabolism
  • Trastuzumab* / adverse effects
  • Trastuzumab* / therapeutic use

Substances

  • Antibodies, Monoclonal, Humanized
  • Camptothecin
  • ERBB2 protein, human
  • Immunoconjugates
  • Receptor, ErbB-2
  • Trastuzumab
  • trastuzumab deruxtecan

Associated data

  • ClinicalTrials.gov/NCT03383692
  • ClinicalTrials.gov/NCT02564900

Grants and funding