Evorpacept plus trastuzumab, ramucirumab and paclitaxel in HER2-positive gastric cancer: a randomized phase 2 trial

Adding the next-generation CD47 inhibitor evorpacept to trastuzumab, ramucirumab and paclitaxel (TRP) produced a higher objective response rate than TRP alone in patients with HER2-positive advanced gastric cancer whose disease had progressed on prior anti-HER2 therapy. The result comes from the randomized phase 2 portion of the phase 2/3 ASPEN-06 trial, a setting where treatment options after anti-HER2 failure remain very limited. Response was associated with tumour CD47 and HER2 expression, suggesting a biomarker strategy to select patients most likely to benefit. Confirmation in the ongoing phase 3 portion is required before the combination can change practice.