Trastuzumab deruxtecan for gastric cancer: HTA assessment of considerable added benefit

Based on a comparative study initiated by the manufacturer prior to marketing authorization, IQWiG now sees a considerable added benefit of treatment with trastuzumab deruxtecan for patients with advanced HER2-positive gastric or gastroesophageal junction adenocarcinoma. The example of the DESTINY-Gastric04 study conducted in parallel with the marketing authorization for trastuzumab for gastric cancer demonstrates that it is both possible and necessary to plan and initiate comparative studies versus the current standard of care even before a drug receives marketing authorization. The sooner, the better. To encourage this, appropriate incentives must also be included in any AMNOG reform.