Safety profile of trastuzumab deruxtecan in advanced breast cancer: Expert opinion on adverse event management

Clin Transl Oncol. 2024 Jul;26(7):1539-1548. doi: 10.1007/s12094-024-03383-x. Epub 2024 Feb 9.

Abstract

Trastuzumab deruxtecan (T-DXd) is an antibody-drug conjugate that targets human epidermal growth factor receptor 2 (HER2) and has shown promising results in the treatment of advanced/metastatic breast cancer. The objective of this report is to provide guidance on the prophylaxis, monitoring, and management of adverse events (AEs) in patients with breast cancer treated with T-DXd, and to emphasize that proper management of AEs is needed to optimize the effectiveness of T-DXd treatment and reduce the number of discontinuations. The article covers various aspects of T-DXd treatment, including its clinical efficacy, safety profile, and dosing considerations, and provides practical recommendations for managing AEs, such as nausea/vomiting, interstitial lung disease, and hematologic toxicity. Although there are still many knowledge gaps about the cause and incidence of AEs in real-world patients, this document may serve as a valuable resource for clinicians who are involved in the care of breast cancer patients receiving T-DXd treatment.

Keywords: Adverse event management; Breast cancer; HER2; Trastuzumab deruxtecan.

Publication types

  • Review

MeSH terms

  • Antineoplastic Agents, Immunological / adverse effects
  • Antineoplastic Agents, Immunological / therapeutic use
  • Breast Neoplasms* / drug therapy
  • Breast Neoplasms* / pathology
  • Camptothecin* / adverse effects
  • Camptothecin* / analogs & derivatives
  • Camptothecin* / therapeutic use
  • Female
  • Humans
  • Immunoconjugates* / adverse effects
  • Immunoconjugates* / therapeutic use
  • Receptor, ErbB-2 / metabolism
  • Trastuzumab* / adverse effects
  • Trastuzumab* / therapeutic use

Substances

  • Trastuzumab
  • trastuzumab deruxtecan
  • Immunoconjugates
  • Camptothecin
  • Antineoplastic Agents, Immunological
  • Receptor, ErbB-2