Would you offer other antibody-drug conjugates to a patient who had a history of G2 trastuzumab deruxtecan-induced pneumonitis that is now resolved?

There are no prospective data to guide this decision; the decision requires careful individualization. TDM-1 (ado-trastuzumab emtansine has a substantially lower pneumonitis risk than trastuzumab deruxtecan (1.6-1.9% with TDM-1 compared to 9.6-10.5% with trastuzumab deruxtecan), and TDM-1 uses a dif...

We aren't seeing a significant incidence of ILD with the other ADCs, so, yes, I would, but would probably avoid datapotamab deruxtecan, given the identical "payload" for that agent as with T-Dxd. Would be comfortable with T-DM1 in a HER2+ patient, or sacituzumab govitecan in a HER2- patient (whether...