Highlight
Recent phase 3 evidence demonstrates that trastuzumab deruxtecan significantly prolongs overall survival compared to ramucirumab plus paclitaxel in patients with HER2-positive metastatic gastric or gastroesophageal junction adenocarcinoma after progression on trastuzumab-based therapy. The safety profile is manageable, with a notable but mostly low-grade risk of interstitial lung disease (ILD) associated with trastuzumab deruxtecan. Complementary real-world data from Japan confirm effectiveness and safety in routine clinical practice.
