The efficacy and safety of trastuzumab deruxtecan (T-DXd) in HER2-expressing solid tumours: a single-arm meta-analysis

• Published in: Japanese journal of clinical oncology Vol. 53; no. 8; pp. 722 - 729
• Main Authors: Kou, Liqiu, Chen, Xiu, Xie, Xiaolu, Wen, Qinglian, Li, Jun, Li, Yaling
• Format: Journal Article
• Language: English
• Published: England Oxford University Press 31.07.2023
• Subjects: Breast Neoplasms - drug therapy; Breast Neoplasms - pathology; Camptothecin - therapeutic use; Female; Humans; Immunoconjugates - adverse effects; Lung Neoplasms - drug therapy; Receptor, ErbB-2; Trastuzumab - adverse effects; trastuzumab deruxtecan (T-DXd); solid tumours; HER2-expressing; safety; antibody-drug couples; meta-analysis; efficacy
• ISSN: 1465-3621; 1465-3621
• DOI: 10.1093/jjco/hyad036

Abstract Objective We performed a meta-analysis to assess the efficacy and safety of T-DXd in the treatment of HER2-expressing solid tumours. Methods We systematically searched PubMed, Web of Science, Embase and the Cochrane Library and collected studies published before March 17, 2023, on T-DXd for HER2-expressing tumours for a meta-analysis. We performed a subgroup analysis based on the different cancer types and the doses used. Results There were 11 studies including 1349 HER2-expressing patients in this meta-analysis. The pooled ORR was 47.91%, and the pooled DCR was 87.01%. The mPFS and mOS combined were 9.63 and 10.71 months, respectively. The most common adverse reactions in grades 1–2 were decreased appetite (49.3%) and vomiting (43.0%). The netropemia (31.2%) and leukopenia (31.2%) were the most common grade 3 and higher adverse reactions. Subgroup analysis showed that breast cancer had the best ORR and DCR, with 66.96 and 96.52%, respectively. Conclusions Overall, the efficacy of T-DXd in treating HER2-expressing solid tumours is encouraging, especially breast and non-small cell lung cancers, and has an acceptable safety profile. However, concerns remain about potentially serious treatment adverse events (e.g. interstitial lung disease/pneumonia). More well-designed, large-scale randomized controlled trials are needed to demonstrate our study. We performed a meta-analysis to assess the efficacy and safety of T-DXd in the treatment of HER2-expressing solid tumours.