USF-LVHN SELECT
A real-world single-center cohort study on the tolerability of trastuzumab deruxtecan for HER2+ metastatic breast cancer.
Publication/Presentation Date
8-4-2025
Abstract
INTRODUCTION: The DESTINY-B01 trial led to trastuzumab deruxtecan (T-DXd) approval for human epidermal growth factor receptor-2 (HER2+) metastatic breast cancers (mBCs), with efficacy further confirmed by DESTINY-B03, demonstrating improved progression-free and overall survival versus trastuzumab emtansine. Despite its efficacy, T-DXd had notable adverse events (AEs), including interstitial lung disease, necessitating real-world studies on safety and tolerability. Findings from such studies may help guide treatment selection and inform risk-benefit discussion in routine clinical practice.
METHODS: A real-world cohort study evaluated the safety and tolerability of T-DXd in patients with HER2+ mBC. De-identified patient data, tumor characteristics, AEs, dose modifications, and discontinuation rates due to AEs were analyzed.
RESULTS: Between January 2020 and June 2024, 85 predominantly non-Hispanic white patients with a median age of 57 years were treated. Notably, 17.6% had an ECOG performance status of 2-3, 69.4% had 1-2 prior metastatic treatments, 94% had visceral involvement, and most received primary prophylaxis with dexamethasone and palonosetron. Approximately 29.4% initiated treatment at a reduced dose; 40% required further dose reductions, primarily due to fatigue (9.4%). Permanent discontinuation due to AEs occurred in 10.6%. Common AEs included fatigue (95.3%), alopecia (14.1%), and peripheral neuropathy (14.1%). Grade ≥3 AEs were infrequent and included neutropenia (10.6%), elevated aspartate aminotransferase (2.4%), elevated alkaline phosphatase (2.4%), and interstitial lung disease (1.2%). No grade 5 events were observed.
CONCLUSION: T-DXd demonstrated acceptable tolerability with manageable AEs in real-world patients with HER2+ mBC, aligning with clinical trial outcomes and supporting its continued use in clinical practice.
First Page
1
Last Page
18
ISSN
1423-0232
Published In/Presented At
Basta, A., Lien, K., Sun, W., Whiting, J., Armitage, M., Soyano, A. E., Armaghani, A., Loftus, L., O'Connor, T., Dvir, K., Han, H. S., Soliman, H., Czerniecki, B. J., & Costa, R. L. B. (2025). A real-world single-center cohort study on the tolerability of trastuzumab deruxtecan for HER2+ metastatic breast cancer. Oncology, 1–18. Advance online publication. https://doi.org/10.1159/000547685
Disciplines
Medical Education | Medicine and Health Sciences
PubMedID
40759100
Department(s)
USF-LVHN SELECT Program, USF-LVHN SELECT Program Students
Document Type
Article