Are there strategies to mitigate the risk of developing ILD/pneumonitis while using trastuzumab deruxtecan?

Although grade 3 toxicity rates were low, ~10.5% experience some degree of ILD, are there strategies to reduce risk before treatment starts? Are there other toxicities of concern given anticipated long term use of therapy?

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How would you handle asymptomatic/incidental ILD in a patient receiving trastuzumab deruxtecan that resolves on imaging 8 weeks later?

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3 Answers

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Medical Oncology · University of Texas MD Anderson Cancer Center

Answered on · Updated on

The most important strategy is global awareness of ILD as a potentially serious complication that may initially present with subtle signs. Patients and all care team members must not only be aware but remind others in the patient/family care circle. This needs to be reinforced regularly. The recogni...

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Medical Oncology · Vall d’Hebron Institute of Oncology

Answered on

At the time being, we do not have specific strategies to mitigate the risk of developing ILD/pneumonitis while using T-DXd. In my opinion, we need prospective data to try to prevent this adverse event which has been reported in the range of 10.5% of patients. However, this event is not unique, and i...

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Medical Oncology · Mary Lanning Healthcare Morrison Cancer Center/University of Nebraska Medical Center Adjunct Faculty

Answered on · Updated on

Pulmonary toxicity of T-DXd may represent off-target toxicity, as other DXd-based ADCs, anti-Trop2 datopotamab deruxtecan, and the anti-HER3 patritumab deruxtecan are capable of inducing ILD. The impact of an increased understanding of T–DXd–related ILD will likely extend beyond breast oncology, giv...

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