Astra’s next Enhertu move is endometrial

Not long after AstraZeneca and Daiichi Sankyo took their HER2-targeting ADC Enhertu into a pivotal ovarian cancer trial, the groups are expanding their efforts into endometrial cancer. The Destiny-Endometrial01 study began in March, but has only just been listed on clinicaltrials.gov. One curiosity about the trial, in first-line, HER2-expressing, mismatch repair proficient (pMMR) disease, is that it includes an arm testing Enhertu plus rilvegostomig, Astra’s anti-TIGIT x PD-1 MAb. TIGIT has had various setbacks, including the recent discontinuation of GSK and Iteos’s belrestotug, followed by Iteos's announcement on Wednesday that it was winding down, but Astra is pressing on with its project and now has 10 rilvegostomig-containing pivotal trials ongoing. Destiny-Endometrial01 also includes an experimental Enhertu plus Keytruda cohort, so perhaps this has more chance of success. Keytruda is already approved in relapsed pMMR endometrial cancer, alongside Lenvima, based on Keynote-775, but this combo failed in the first-line Leap-001 trial. Chemo combos of Keytruda and of GSK's Jemperli are also approved for first-line endometrial cancer, irrespective of MMR status. As monotherapies both are approved for relapsed dMMR disease.

Phase 3 trials of rilvegostomig

Source: OncologyPipeline & clinicaltrials.gov.