Colon cancer treated with Enhertu
Enhertu is an antibody-drug conjugate composed of a chemotherapy bound to an anti-HER2 antibody.
Recently, in December 2019, Enhertu received accelerated approval by the FDA to treat unresectable or metastatic HER2-positive breast cancer patients based on the unremarkable outcomes demonstrated in the study.
Enhertu was assessed in colon cancer and these are the results.
About DESTINY-CRC01 study
Early studies have shown promising activity in advanced HER2-expressing tumors.
DESTINY-CRC01 study is a phase 2 multicenter study of Enhertu in patients with HER2-expressing metastatic colorectal cancer. Patients with HER2 positive, RAS–wild type metastatic colorectal cancer that progressed on up to 2 prior treatment lines received Enhertu in 3 groups in the study:
Group A – Patients whose tumors express HER2 IHC 3+ or IHC 2+/ISH+
Group B – Patients whose tumors express IHC 2+/ISH2
Group C – Patients whose tumors express IHC 1+
Results in colon cancer
At the time data was collected for the analysis, 78 patients were enrolled to the study. Group A with 53 patients, group B with 7 patients and group C with 18 patients.
All patients had received Enhertu.
In arm A
- 45.3% of patients had responded well to Enhertu treatment with 1 patient who achieved complete remission and 23 patients had their cancer shrunken.
- Of the patients who previously received an anti-HER2 therapy, 43.8% responded to Enhertu treatment and had their cancer stopped from growing or shrunken.
- 83% of patients had some degree of positive response to Enhertu.
- The median time until the disease had progressed from the start of Enhertu was 6.9 months
- The median survival was not reached(!) all patients were alive at the time of the collection of study data for analysis.
In arms B and C
No patient had responded to the treatment, no control on tumor growth and no shrinkage in tumor sized were observed.
Side Effects among colon cancer patients
61.5% of patients experienced severe side effects.
The most common were decreased neutrophil count (21.8%) and anemia (14.1%).
7 patients (9%) had to drug discontinue the treatment.
5 patients (6.4%) had interstitial lung disease (ILD) of whom 2 died from.
Conclusions
- Overall, Enhertu demonstrated remarkable activity in patients with HER2 positive metastatic colorectal cancer refractory to standard therapies, with a safety profile consistent with previous results.
- ILD is an important risk and requires careful recognition and intervention.
The best treatment for a cancer patient is to get the most advanced cancer drugs in advanced stages of development. There, the hope and the chance to extend life go far beyond the standard protocols.
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