ArticlePakistan journal of medical sciences2026
Trastuzumab Deruxtecan as a Salvage Therapy after Disitamab Vedotin Failure in HER2 Altered Solid Tumors: A Preliminary Real-world Comparative Study.
Article in Pakistan journal of medical sciences, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background & Objective: To compare the efficacy and safety of two human epidermal growth factor receptor 2 (HER2)-targeting antibody-drug conjugates (ADCs), disitamab vedotin (RC48) and trastuzumab deruxtecan (DS-8201), in patients with the HER2 altered solid tumors. Methodology: We conducted a preliminary real-world comparative study, which included a case of a patient with HER2 exon 20 insertion mutated lung adenocarcinoma and a retrospective analysis of 18 patients treated at Air Force Medical Hospital, PLA, Beijing between 2021 and 2025. Patients received either RC48 (n=12) or DS-8201 (n=6). The primary endpoints were objective response and adverse events, evaluated using RECIST 1.1 criteria and standard toxicity assessments. Results: The case patient exhibited primary resistance and severe gastrointestinal toxicity to RC48 but achieved partial remission (PR) with DS-8201. In the cohort analysis, DS-8201 demonstrated a significantly superior PR of 66.67% compared to 8.33% for RC48 (P = 0.022). The adverse event profiles differed notably: DS-8201 was primarily associated with elevated transaminases and fatigue, while RC48 more frequently caused myelosuppression and hyperbilirubinemia. Conclusion: DS-8201 demonstrates potential as one of the effective salvage therapies following RC48 failure in HER2 altered solid tumors, showing significantly better disease control and a distinct, manageable toxicity profile. These findings highlight the importance of selecting personalized ADCs based on molecular subtypes and toxicity factors and provide a basis for future, larger-scale prospective studies.
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