In 2023, approximately 15 thousand new cases of stomach cancer have been estimated in Italy (9000 men and 6000 women). 20% have overexpression of the Her2 protein. Patients with advanced metastatic disease, who have progressed after first-line anti-Her2 treatment, can now benefit from a new drug (trastuzumab deruxtecan), a monoclonal antibody drug-conjugate. The Italian Medicines Agency (Aifa) has in fact approved the reimbursement of trastuzumab deruxtecan as monotherapy for the treatment of adult patients with Her2-positive advanced adenocarcinoma of the stomach or gastroesophageal junction, who have received previous treatment based on trastuzumab.
In December 2022, trastuzumab deruxtecan was approved by the European Commission in this indication based on the results of the Destiny-Gastric01 and Destiny-Gastric02 studies. It is the first anti-Her2 drug approved in the European Union in over a decade for gastric cancer.
“Trastuzumab deruxtecan has proven to be effective in a complex clinical condition, i.e. in patients with Her2-positive gastric cancer not amenable to surgery, after the failure of the first line of medical therapy consisting of chemotherapy plus trastuzumab – explains Sara Lonardi, Director of the Oncology 3 at the Veneto Irccs Oncology Institute in Padua -. In these cases, until now, the possibilities of treatment were limited. It is an Adc (antibody-drug conjugate) type drug, which combines a monoclonal antibody, trastuzumab, with a chemotherapy drug, deruxtecan”.
“The research makes innovative treatments available to patients such as trastuzumab deruxtecan, which represents a significant step forward in the control of metastatic disease – underlines Claudia Santangelo, president of the patient association ‘Living without a stomach (it’s possible)’ -. Gastric cancer is a pathology of high clinical complexity and requires dedicated paths for diagnosis, treatment and assistance. The management of these patients, particularly with advanced cancer, requires a multidisciplinary approach that allows global management, improving survival and quality of life”.
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