Optimizing treatment management of trastuzumab deruxtecan in clinical practice of breast cancer

Rugo, Hope S.; Cortés, Javier; Henning, Jan-Willem; Untch, Michael

doi:10.1016/j.esmoop.2022.100553

Cited by 50 publications

(62 citation statements)

References 48 publications

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“…Laut der von Rugo vorgestellten 2. Interimsanalyse überzeugte SG nun auch durch eine signifikante OS-Verlängerung 5 : Die Kontrollpatientinnen überlebten median 11,2 Monate, die mit SG behandelten Frauen dagegen 14,4 Monate (HR 0,79; p = 0,020). Die 12-Monatsrate des OS lag im Kontrollarm bei 47 gegenüber 61 % unter SG.…”

Section: Trop-2 Als Target: Längeres Os Bessere Lebensqualitätunclassified

Neue Therapieansätze beim Mammakarzinom

Arnheim¹

2023

Onkologische Welt

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Section: Trop-2 Als Target: Längeres Os Bessere Lebensqualitätunclassified

Neue Therapieansätze beim Mammakarzinom

Arnheim¹

2023

Onkologische Welt

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“…A pooled analysis of eight single-arm, phase I and II, T-DXd monotherapy studies found that 15.8% of the total patient population (139 of 879) developed ILD or pneumonitis. 11,12 ILD or pneumonitis can also lead to death with 2.7% of patients in the DESTINY-Breast01 trial having a fatal event. 13 However, more recent trials of T-DXd have shown a lower rate of death from ILD and/or pneumonitis, likely because of recognition of this important toxicity, with only 0.8% suffering ILD-related death in DESTINY Breast04.…”

Section: Question: How Do Clinicians Optimally Manage Adverse Events ...mentioning

confidence: 99%

“…12 Systemic glucocorticoids should be initiated (≥0.5 mg/kg/daily prednisone or equivalent) until improvement, followed by a taper over at least 4 weeks. 12 If ILD and/or pneumonitis was asymptomatic and found on scans only (grade 1), T-DXd can be resumed if the radiologic findings resolve completely. 12 If symptomatic ILD and/or pneumonitis occurs (grade 2, 3, or 4), T-DXd should be discontinued permanently.…”

Section: Question: How Do Clinicians Optimally Manage Adverse Events ...mentioning

confidence: 99%

“…ILD and/or pneumonitis should be confirmed by evaluation, including CT of the chest, pulmonology consultation, with consideration of bronchoscopy or BAL and pulmonary function tests. 12 Systemic glucocorticoids should be initiated (≥0.5 mg/kg/daily prednisone or equivalent) until improvement, followed by a taper over at least 4 weeks. 12 If ILD and/or pneumonitis was asymptomatic and found on scans only (grade 1), T-DXd can be resumed if the radiologic findings resolve completely.…”

Section: Question: How Do Clinicians Optimally Manage Adverse Events ...mentioning

confidence: 99%

“…12 If ILD and/or pneumonitis was asymptomatic and found on scans only (grade 1), T-DXd can be resumed if the radiologic findings resolve completely. 12 If symptomatic ILD and/or pneumonitis occurs (grade 2, 3, or 4), T-DXd should be discontinued permanently. 12…”

Section: Question: How Do Clinicians Optimally Manage Adverse Events ...mentioning

confidence: 99%

See 2 more Smart Citations

Chemotherapy and Targeted Therapy for Endocrine-Pretreated or Hormone Receptor–Negative Metastatic Breast Cancer and Human Epidermal Growth Factor Receptor 2 Testing in Breast Cancer: ASCO Guideline Rapid Recommendation Update Q and A

Moy

Wolff

Rumble

et al. 2023

JCO Oncology Practice

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Clinical and imaging features of interstitial lung disease in cancer patients treated with trastuzumab deruxtecan

Baba,

Kusumoto,

Kato

et al. 2023

Int J Clin Oncol

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Background Interstitial lung disease/pneumonitis (ILD/pneumonitis) has been identified as a drug-related adverse event of special interest of trastuzumab deruxtecan (T-DXd), but there were a few reports of T-DXd-related ILD/pneumonitis in clinical practice. Methods Between May 25, 2020 (the launch of T-DXd in Japan) and February 24, 2022, there were 287 physician-reported potential ILD/pneumonitis cases from the Japanese post-marketing all-case surveillance. By February 27, 2022, an independent adjudication committee assessed 138 cases and adjudicated 130 cases as T-DXd-related ILD/pneumonitis. The clinical features and imaging characteristics of these cases were evaluated. Results The majority of adjudicated T-DXd-related ILD/pneumonitis cases were grade 1 or 2 (100/130, 76.9%). The most common radiological pattern types observed were organizing pneumonia patterns (63.1%), hypersensitivity pneumonitis patterns (16.9%), and diffuse alveolar damage (DAD) patterns (14.6%). Eleven cases (8.5%) from 130 resulted in death; the majority of these (8/11, 72.7%) had DAD patterns. The overall proportion of recovery (including the outcomes of recovered, recovered with sequelae, and recovering) was 76.9%, and the median time to recovery was 83.5 days (interquartile range: 42.25–143.75 days). Most cases (59/71, 83.1%) that were treated with corticosteroids were considered responsive to treatment. Conclusions This is the first report to evaluate T-DXd-related ILD/pneumonitis cases in clinical practice. Our findings are consistent with previous reports and suggest that patients with DAD patterns have poor outcomes. Evaluation of a larger real-world dataset may further identify predictors of clinical outcome.

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Optimizing treatment management of trastuzumab deruxtecan in clinical practice of breast cancer

Cited by 50 publications

References 48 publications

Neue Therapieansätze beim Mammakarzinom

Neue Therapieansätze beim Mammakarzinom

Chemotherapy and Targeted Therapy for Endocrine-Pretreated or Hormone Receptor–Negative Metastatic Breast Cancer and Human Epidermal Growth Factor Receptor 2 Testing in Breast Cancer: ASCO Guideline Rapid Recommendation Update Q and A

Clinical and imaging features of interstitial lung disease in cancer patients treated with trastuzumab deruxtecan

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