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Trastuzumab deruxtecan + ramucirumab is an investigational combination therapy being evaluated for the treatment of HER2-low gastric and gastroesophageal junction (GEJ) adenocarcinoma. Trastuzumab deruxtecan (T-DXd) is an antibody-drug conjugate (ADC) comprising a humanized anti-HER2 antibody linked to a topoisomerase I inhibitor payload (deruxtecan); it targets HER2-expressing cells and delivers a cytotoxic payload to induce cell death. Ramucirumab is a fully human IgG1 monoclonal antibody that acts as a vascular endothelial growth factor receptor 2 (VEGFR2) antagonist, inhibiting angiogenesis by blocking the binding of VEGF ligands. This combination, currently being studied in a Phase Ib/II trial sponsored by Yonsei University, aims to enhance therapeutic efficacy in patients with low HER2 expression who have progressed on prior therapies.
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