686 Participants Needed

Trastuzumab Deruxtecan + Pembrolizumab for Lung Cancer

(DESTINY-Lung06 Trial)

Recruiting at 26 trial locations
Cf
Overseen ByContact for Trial Information
Age: 18+
Sex: Any
Trial Phase: Phase 3
Sponsor: Daiichi Sankyo
No Placebo GroupAll trial participants will receive the active study treatment (no placebo)
Pivotal Trial (Near Approval)This treatment is in the last trial phase before FDA approval
Prior Safety DataThis treatment has passed at least one previous human trial
Breakthrough TherapyThis drug has been fast-tracked for approval by the FDA given its high promise

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to evaluate the effectiveness of a new drug combination for treating non-squamous non-small cell lung cancer. It compares trastuzumab deruxtecan (a targeted therapy) and pembrolizumab (an immunotherapy drug) with traditional chemotherapy plus pembrolizumab. The trial focuses on individuals who have not yet received treatment for their advanced lung cancer, particularly those with tumors that have specific features (HER2-overexpressing and a PD-L1 TPS less than 50%) not addressed by other available treatments. This trial may suit someone with untreated advanced lung cancer whose daily life is affected by the disease. As a Phase 3 trial, it represents the final step before FDA approval, offering participants access to potentially groundbreaking treatment.

Do I need to stop my current medications to join the trial?

The trial information does not specify whether you need to stop taking your current medications. It's best to discuss this with the trial coordinators or your doctor.

Is there any evidence suggesting that this trial's treatments are likely to be safe?

Research has shown that trastuzumab deruxtecan (T-DXd) works well for patients with advanced HER2-positive or low cancers. It has led to strong and lasting improvements in those who have undergone previous treatments. Reports indicate that the safety of T-DXd is generally as expected, although a lung condition called interstitial lung disease (ILD) has been noted as a side effect.

Pembrolizumab, a common cancer treatment, is generally well-tolerated. It is already approved for use in various cancers, indicating that its safety is well understood.

Overall, the combination of these treatments has been tested. While side effects like ILD occur, they align with past patient experiences.12345

Why are researchers excited about this trial's treatments?

Researchers are excited about combining Trastuzumab Deruxtecan (T-DXd) with Pembrolizumab for lung cancer because T-DXd is a targeted therapy that specifically attacks cancer cells expressing the HER2 protein. Unlike other treatments that generally target all rapidly dividing cells, this combination aims to deliver chemotherapy directly to cancer cells, minimizing damage to healthy cells. On the other hand, the combination of Pemetrexed, platinum-based chemotherapy, and Pembrolizumab in the comparator arm is already a standard treatment, but it does not offer the targeted approach that T-DXd provides. The hope is that this unique mechanism will result in more effective treatment with potentially fewer side effects.

What evidence suggests that this trial's treatments could be effective for lung cancer?

Research has shown that a combination of two drugs, trastuzumab deruxtecan (T-DXd) and pembrolizumab, may be promising for treating non-small cell lung cancer (NSCLC) with high levels of HER2. In this trial, participants in Arm A will receive this combination. Early studies found that patients with this cancer type responded well to the drug combination, especially those not previously treated with immune checkpoint inhibitors. These inhibitors help the immune system fight cancer. This suggests that the combination might outperform standard treatments for this specific cancer type. However, while the early results are encouraging, further research is needed to confirm these findings.678910

Are You a Good Fit for This Trial?

This trial is for adults with advanced non-squamous lung cancer that overexpresses HER2 and hasn't spread widely. They haven't had systemic cancer treatment for this condition but may have had certain other therapies if it's been 6 months since the last dose without disease progression. Participants need a recent or new biopsy showing HER2 and PD-L1 levels, must sign consent forms, and can't have specific gene alterations treatable by existing drugs.

Inclusion Criteria

I have signed all required consent forms for the trial.
I have signed all required consent forms for genetic testing and, if applicable, for a pregnant partner.
My cancer is advanced, cannot be surgically removed, and is not squamous.
See 6 more

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants receive either T-DXd plus pembrolizumab or Pemetrexed plus platinum chemotherapy (cisplatin or carboplatin) plus pembrolizumab

54 months

Follow-up

Participants are monitored for overall survival and progression-free survival

85 months

What Are the Treatments Tested in This Trial?

Interventions

  • Pembrolizumab
  • Pemetrexed
  • Trastuzumab Deruxtecan
Trial Overview The study compares Trastuzumab Deruxtecan (T-DXd) plus Pembrolizumab against platinum-based chemotherapy with Pembrolizumab in patients who are receiving their first treatment for locally advanced or metastatic lung cancer with high levels of HER2 protein. The goal is to see which combination works better.
How Is the Trial Designed?
2Treatment groups
Experimental Treatment
Active Control
Group I: Arm A: T-DXdExperimental Treatment2 Interventions
Group II: Arm B: Pemetrexed + Chemotherapy + PembrolizumabActive Control3 Interventions

Find a Clinic Near You

Who Is Running the Clinical Trial?

Daiichi Sankyo

Lead Sponsor

Trials
443
Recruited
493,000+
Hiroyuki Okuzawa profile image

Hiroyuki Okuzawa

Daiichi Sankyo

Chief Executive Officer

Degree in Social Sciences from Hitotsubashi University

Yuki Abe profile image

Yuki Abe

Daiichi Sankyo

Chief Medical Officer since 2023

MD

Merck Sharp & Dohme LLC

Industry Sponsor

Trials
4,096
Recruited
5,232,000+
Chirfi Guindo profile image

Chirfi Guindo

Merck Sharp & Dohme LLC

Chief Marketing Officer since 2022

Degree in Engineering from Ecole Centrale de Paris, MBA from New York University Stern School of Business

Robert M. Davis profile image

Robert M. Davis

Merck Sharp & Dohme LLC

Chief Executive Officer since 2021

JD from Northwestern University Pritzker School of Law, MBA from Northwestern University Kellogg Graduate School of Management, Bachelor's in Finance from Miami University

Citations

P3.18.58 Trastuzumab Deruxtecan + Pembrolizumab as ...However, survival outcomes are modest in patients with PD-L1 tumor proportion score (TPS) <50%. Additionally, no first-line HER2-directed therapies are approved ...
NCT06899126 | Study of Trastuzumab Deruxtecan ...This clinical trial is designed to assess the efficacy and safety of trastuzumab deruxtecan (T-DXd; Enhertu®) in combination with pembrolizumab versus ...
Trastuzumab deruxtecan for the treatment of metastatic non ...We reported treatment information and outcomes of four patients with metastatic NSCLC harboring HER2 non-exon 19/20 mutations who were treated ...
Trastuzumab Deruxtecan + Pembrolizumab as First-Line ...However, efficacy outcomes with pembrolizumab + platinum-based ... patients with HER2-overexpressing non–small cell lung cancer (NSCLC).
T-DXd Plus Pembrolizumab Elicits Responses in IO-Naive ...Trastuzumab deruxtecan plus pembrolizumab showed early efficacy in patients with IO-naive, HER2-expressing or -mutant non–small cell lung cancer.
Real-world safety and efficacy profiles of trastuzumab ...Trastuzumab deruxtecan (T-DXd) is an effective therapy for patients with human epidermal growth factor receptor 2 (HER2)-positive/low advanced ...
Final Analysis Results and Patient-Reported Outcomes ...Trastuzumab deruxtecan (T-DXd) demonstrated strong and durable responses in patients with previously treated HER2 (ERBB2) mutant (HER2m) ...
NCT06899126 | Study of Trastuzumab Deruxtecan ...This clinical trial is designed to assess the efficacy and safety of trastuzumab deruxtecan (T-DXd; Enhertu®) in combination with pembrolizumab versus ...
DESTINY-Lung06 Phase 3 Trial of ENHERTU Initiated as ...DESTINY-Lung06 is a multicenter, randomized, open-label, phase 3 trial evaluating the efficacy and safety of ENHERTU (5.4 mg/kg) in combination ...
Efficacy and Safety of Trastuzumab Deruxtecan in Patients ...Our study demonstrates durable clinical benefit, meaningful survival outcomes, and safety consistent with the known profile (including ILD) in pretreated ...
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