Trastuzumab deruxtecan kills skin and uveal melanoma in vivo by HER2-independent payload release

Background

HER2-directed CAR-T cells can eradicate melanoma despite low HER2 expression. We therefore asked whether melanoma would also respond to trastuzumab deruxtecan (T-DXd), an antibody-drug conjugate targeting HER2. Patients and methods: T-DXd was evaluated in several patient-derived xenograft (PDX) models and as a compassionate use in one patient with metastatic uveal melanoma. We compared T-DXd with another ADC, trastuzumab emtansine (T-DM1), and examined ADC sensitivity and trastuzumab uptake in vitro, and expression of HER2 and cathepsin L (CTSL) in xenografts.