TY - JOUR
T1 - Multidisciplinary clinical guidance on trastuzumab deruxtecan (T-DXd)–related interstitial lung disease/pneumonitis—Focus on proactive monitoring, diagnosis, and management
AU - Swain, Sandra M.
AU - Nishino, Mizuki
AU - Lancaster, Lisa H.
AU - Li, Bob T.
AU - Nicholson, Andrew G.
AU - Bartholmai, Brian J.
AU - Naidoo, Jarushka
AU - Schumacher-Wulf, Eva
AU - Shitara, Kohei
AU - Tsurutani, Junji
AU - Conte, Pierfranco
AU - Kato, Terufumi
AU - Andre, Fabrice
AU - Powell, Charles A.
N1 - Funding Information:
All authors received nonfinancial support (assistance with manuscript preparation) from ArticulateScience LLC, funded by AstraZeneca. Additional disclosures are as follows: SMS reports grants/contracts from Breast Cancer Research Foundation, Genentech/Roche, and Kailos Genetics, consulting fees from AstraZeneca, Daiichi Sankyo, Molecular Templates, Silverback Therapeutics, Eli Lilly, Merck, Natera, Exact Sciences, Athenex, Biotheranostics, and Genentech/Roche, honoraria from Genentech/Roche, Daiichi Sankyo, and Beijing Medical Foundation, 3rd party writing in kind Genentech/Roche travel support from Genentech/Roche, Caris, and Daiichi Sankyo, serving on Data and Safety Monitoring Committee for AstraZeneca, and leadership or a fiduciary role for ASCO Conquer Cancer Foundation and The National Surgical Adjuvant Breast and Bowel Project Foundation, outside of the submitted work; MN reports grants/contracts to the institution from Canon Medical Systems, AstraZeneca, and Daiichi Sankyo, and consulting fees from AstraZeneca and Daiichi Sankyo, outside of the submitted work; LHL reports grants/contracts from FibroGen, Novartis, Celgene, Biogen, Pliant, Galecto, Boehringer Ingelheim, Respivant, Bristol Myers Squibb, Genentech, and Galapagos, consulting fees from AstraZeneca, Boehringer Ingelheim, Genentech, Galapagos, Veracyte, and DevPro Biopharma, honoraria from Genentech, Boehringer Ingelheim, and Veracyte, serving on advisory/data safety monitoring boards or steering committees for Senhwa, Bellerophon, and United Therapeutics, and leadership or a fiduciary role for Pulmonary Fibrosis Foundation Registry Steering Committee, outside of the submitted work; BTL reports grants/contracts from the National Institutes of Health, AstraZeneca, and Daiichi Sankyo, during the submitted work, and grants/contracts from Amgen, Eli Lilly, Genentech/Roche, Hengrui USA, and Bolt Biotherapeutics, royalties or licenses from Karger Publishers and Shanghai Jiao Tong University Press, travel support from MORE Health and Jiangsu Hengrui Medicine, and two institutional patents at Memorial Sloan Kettering Cancer Center (US62/685,057, US62/514,661), outside of the submitted work; AGN reports consulting fees from Galapagos, Boehringer Ingelheim, Roche, and Medical Quantitative Image Analysis, and honoraria from UpToDate and Boehringer Ingelheim, outside of the submitted work; BJB reports grants/contracts from the National Institutes of Health/National Cancer Institute and Hurvis Foundation, royalties from Imbio, consulting fees from AstraZeneca, and two patents (patent number: 11026641; publication number: 20180061049), outside of the submitted work; JN reports grants/contracts from Merck, AstraZeneca, and Bristol Myers Squibb, consulting fees from Merck, AstraZeneca, Bristol Myers Squibb, Pfizer, Daiichi Sankyo, Takeda, and Roche/Genentech, honoraria from Merck, AstraZeneca, Bristol Myers Squibb, Pfizer, Takeda, and Roche/Genentech, travel support from Merck, and serving on advisory boards for Daiichi Sankyo, outside of the submitted work; KS reports grants/contracts from Astellas, Eli Lilly, Ono, Sumitomo Dainippon, Daiichi Sankyo, Taiho, Chugai, MSD, Medi Science, and Eisai, consulting fees from Astellas, Eli Lilly, Bristol Myers Squibb, Takeda, Pfizer, Ono, MSD, Taiho, Novartis, AbbVie, GlaxoSmithKline, Daiichi Sankyo, Amgen, and Boehringer Ingelheim, and honoraria from Novartis, AbbVie, and Yakult, outside of the submitted work; JT reports travel support and honoraria from Daiichi Sankyo, and serving on advisory boards for Daiichi Sankyo, outside of the submitted work; TK reports grants/contracts from Regeneron, AbbVie, Amgen, AstraZeneca, Bristol Myers Squibb, Chugai, Eli Lilly, Merck Biopharma, MSD, Novartis, Ono, Pfizer, and Taiho, payment or honoraria from AstraZeneca, Boehringer Ingelheim, Bristol Myers Squibb, Chugai, Daiichi Sankyo, Eli Lilly, Merck Biopharma, MSD, Novartis, Ono, Pfizer, and Roche, serving on advisory/data safety monitoring boards with honoraria for AbbVie, Amgen, AstraZeneca, Chugai, Daiichi-Sankyo, Eli Lilly, Merck Biopharma, MSD, Nippon Kayaku, Novartis, Ono, Pfizer, Taiho, and Takeda, and spousal employment at Eli Lilly, outside of the submitted work; FA reports grants/contracts from AstraZeneca, Daiichi Sankyo, Novartis, Sanofi, Roche Genentech, Lilly, and Pfizer, travel support from Pfizer, and serving on advisory boards for AstraZeneca, Daiichi Sankyo, Novartis, Sanofi, Roche/Genentech, Eli Lilly, and Pfizer, outside of the submitted work; and CAP reports personal fees from Daiichi Sankyo, AstraZeneca, Voluntis, Bristol Meyers Squibb, Senhwa Biosciences, and Eisai, outside of the submitted work. ES-W and PC do not have any disclosures to report.
Funding Information:
Medical writing support was provided by Samantha Keller, PhD, of ArticulateScience LLC, and funded by AstraZeneca in accordance with Good Publication Practice (GPP3) guidelines ( http://www.ismpp.org/gpp3 ). The manuscript was reviewed for medical accuracy by AstraZeneca and Daiichi Sankyo; however, the authors retained full control of the content and made the final decisions for all aspects of this article. Bob T. Li was supported by the Memorial Sloan Kettering Cancer Center Support Grant P30 CA008748 and Research Project Grant 1R01CA249666-01A1 from the National Institutes of Health.
Publisher Copyright:
© 2022 The Author(s)
PY - 2022/5
Y1 - 2022/5
N2 - Trastuzumab deruxtecan (T-DXd; DS-8201) is an antibody-drug conjugate targeting human epidermal growth factor receptor 2. Interstitial lung disease (ILD)/pneumonitis is an adverse event associated with T-DXd; in most cases, it is low grade (grade ≤ 2) and can be treated effectively but may develop to be fatal in some instances. It is important to increase patient and provider understanding of T-DXd–related ILD/pneumonitis to improve patient outcomes. Drug-related ILD/pneumonitis is a diagnosis of exclusion; other possible causes of lung injury/imaging findings must be ruled out for an accurate diagnosis. Symptoms can be nonspecific, and identifying early symptoms is challenging; therefore, diagnosis is often delayed. We reviewed characteristics of patients who developed T-DXd–related ILD/pneumonitis and its patterns, produced multidisciplinary guidelines on diagnosis and management, and described areas for future investigation. Ongoing studies are collecting data on T-DXd–related ILD/pneumonitis to further our understanding of its clinical patterns and mechanisms. Search strategy and selection criteria: References were identified based on the guidelines used by the authors in treating interstitial lung disease and pneumonitis. Searches of the authors’ own files were also completed. A search of PubMed with the search terms (trastuzumab deruxtecan) AND (interstitial lung disease) AND (guidelines) was conducted on November 1, 2021, with no restrictions based on publication date, and the two articles yielded by the search were included.
AB - Trastuzumab deruxtecan (T-DXd; DS-8201) is an antibody-drug conjugate targeting human epidermal growth factor receptor 2. Interstitial lung disease (ILD)/pneumonitis is an adverse event associated with T-DXd; in most cases, it is low grade (grade ≤ 2) and can be treated effectively but may develop to be fatal in some instances. It is important to increase patient and provider understanding of T-DXd–related ILD/pneumonitis to improve patient outcomes. Drug-related ILD/pneumonitis is a diagnosis of exclusion; other possible causes of lung injury/imaging findings must be ruled out for an accurate diagnosis. Symptoms can be nonspecific, and identifying early symptoms is challenging; therefore, diagnosis is often delayed. We reviewed characteristics of patients who developed T-DXd–related ILD/pneumonitis and its patterns, produced multidisciplinary guidelines on diagnosis and management, and described areas for future investigation. Ongoing studies are collecting data on T-DXd–related ILD/pneumonitis to further our understanding of its clinical patterns and mechanisms. Search strategy and selection criteria: References were identified based on the guidelines used by the authors in treating interstitial lung disease and pneumonitis. Searches of the authors’ own files were also completed. A search of PubMed with the search terms (trastuzumab deruxtecan) AND (interstitial lung disease) AND (guidelines) was conducted on November 1, 2021, with no restrictions based on publication date, and the two articles yielded by the search were included.
UR - http://www.scopus.com/inward/record.url?scp=85129448178&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85129448178&partnerID=8YFLogxK
U2 - 10.1016/j.ctrv.2022.102378
DO - 10.1016/j.ctrv.2022.102378
M3 - Review article
C2 - 35430509
AN - SCOPUS:85129448178
VL - 106
JO - Cancer Treatment Reviews
JF - Cancer Treatment Reviews
SN - 0305-7372
M1 - 102378
ER -