Multidisciplinary clinical guidance on trastuzumab deruxtecan (T-DXd)-related interstitial lung disease/pneumonitis-Focus on proactive monitoring, diagnosis, and management. [Review]
Multidisciplinary clinical guidance on trastuzumab deruxtecan (T-DXd)-related interstitial lung disease/pneumonitis-Focus on proactive monitoring, diagnosis, and management. [Review]
- 2022
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. Copyright ♭ 2022 The Author(s). Published by Elsevier Ltd.. All rights reserved.
English
0305-7372
10.1016/j.ctrv.2022.102378 [doi] S0305-7372(22)00042-1 [pii]
*Immunoconjugates
*Lung Diseases, Interstitial
*Pneumonia
Camptothecin/aa [Analogs & Derivatives]
Humans
Immunoconjugates/tu [Therapeutic Use]
Lung Diseases, Interstitial/co [Complications]
Lung Diseases, Interstitial/di [Diagnosis]
Lung Diseases, Interstitial/dt [Drug Therapy]
Pneumonia/co [Complications]
Pneumonia/dt [Drug Therapy]
Trastuzumab/ae [Adverse Effects]
Associate Dean for Research Development
MedStar Health
Journal Article
Review
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. Copyright ♭ 2022 The Author(s). Published by Elsevier Ltd.. All rights reserved.
English
0305-7372
10.1016/j.ctrv.2022.102378 [doi] S0305-7372(22)00042-1 [pii]
*Immunoconjugates
*Lung Diseases, Interstitial
*Pneumonia
Camptothecin/aa [Analogs & Derivatives]
Humans
Immunoconjugates/tu [Therapeutic Use]
Lung Diseases, Interstitial/co [Complications]
Lung Diseases, Interstitial/di [Diagnosis]
Lung Diseases, Interstitial/dt [Drug Therapy]
Pneumonia/co [Complications]
Pneumonia/dt [Drug Therapy]
Trastuzumab/ae [Adverse Effects]
Associate Dean for Research Development
MedStar Health
Journal Article
Review