Evaluating trastuzumab deruxtecan in patients with gastrooesophageal adenocarcinoma who are ctDNA and HER2 positive: DECIPHER

Smyth, E., Griffiths, D., Cozens, K., Ewings, S., Waugh, R., Turkington, R.C., Foley, K., Roy, R., Ngan, S., Owen, R., Chuter, D., Steele, C. and Griffiths, G. 2024. Evaluating trastuzumab deruxtecan in patients with gastrooesophageal adenocarcinoma who are ctDNA and HER2 positive: DECIPHER. ESMO Gastrointestinal Oncology 6 , 100114. 10.1016/j.esmogo.2024.100114

PDF - Published Version Available under License Creative Commons Attribution. Download (475kB)

Abstract

Operable gastrooesophageal adenocarcinoma (GOA) is treated with multimodality therapy which is curative in <50% of patients. Patients in the UK with operable GOA are treated with chemotherapy before and following surgery. Patients who have circulating tumour DNA (ctDNA) present after surgery have worse survival than ctDNA-negative patients. Trastuzumab deruxtecan (T-DXd), a novel human epidermal growth factor receptor 2 (HER2)-targeting antibody–drug conjugate is an effective drug in multiple tumour types and has been licensed to treat advanced HER2-positive GOA that has progressed after chemotherapy and trastuzumab and is European Society for Medical Oncology (ESMO) Guideline recommended. Evaluation of T-DXd in operable but micrometastatic GOA is an attractive option. DECIPHER is a multicentre, phase II trial testing the efficacy of T-DXd in reducing micrometastatic disease burden in HER2-positive GOA patients who are ctDNA positive after neoadjuvant chemotherapy and surgery. Patients will have their resection specimen and plasma analysed to confirm HER2 and ctDNA status post-operatively. Twenty-five ctDNA- and HER2-positive patients will be treated with 6.4 mg/kg T-DXd intravenously every 21 days for a maximum of eight cycles. Study follow-up visits will take place for a maximum of 2 years after treatment, with survival follow-up until the end of the study.

Item Type:	Article
Date Type:	Publication
Status:	Published
Schools:	Schools > Medicine
ISSN:	2949-8198
Date of First Compliant Deposit:	12 December 2025
Last Modified:	12 Dec 2025 16:30
URI:	https://orca.cardiff.ac.uk/id/eprint/183204

Actions (repository staff only)

Edit Item