ESMO Open review: Shadows under the halo of "magic medicine"?

Trastuzumab deruxtecan (T-DXd, DS-8201) is an antibody-drug conjugate (ADC) composed of an anti-human epidermal growth factor receptor 2 (HER2) humanized monoclonal antibody, a tetrapeptidyl cleavable linker and topoisomerase I inhibitor loading, the ratio of drug to antibody is high (about 8:1)

Interstitial lung disease (ILD)/pneumonitis is a known risk of multiple cancer therapies, including multiple ADCs

In 2019, research-specific guidelines for monitoring, evaluating, and managing ILD/pneumonitis in T-DXd clinical trials were updated, including recommendations for dose adjustment and supportive care (Table 1)

To characterize DS8201-related ILD/pneumonitis, we performed a pooled analysis of nine phase I and phase II DS8201 monotherapy studies across multiple tumor types

A total of 1150 patients were included in the analysis (breast cancer, 44.

In this pooled analysis of heavily treated patients, the incidence of ILD/pneumonitis was 15.

Original source:

CA Powell, S.