I think that phase 3 data are needed but not in the second-line setting. I think a phase 3 trial in the first-line setting of T-Dxd versus chemo +/- IO is the way to go.Based on DESTINY-Lung01, trastuzumab deruxtecan is more effective than other HER2 targeted strategies overall.

The phase 2 data appears sufficient to change practice for second line therapy. Just a reminder, in the phase 2 DESTINY-Lung01 study, patients who had progressed following one or more systemic therapies were enrolled. The confirmed ORR by ICR of 54.9% is far better than what docetaxel +/- ramuciruma...

I think that the results of the DESTINY-Lung 01 study are enough to change practice in HER-2 mutant non-small cell lung cancer, at least in the second line setting. In the first-line setting however, I would prefer to see randomized control trial comparing trastuzumab deruxtecan to chemoimmunotherap...