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Topics:
Lung Cancer • Breast Cancer • Thoracic Malignancies • Medical Oncology • Her2+ • Internal Medicine • Pulmonology • Journal Club ft. NEJM publications
What strategies can be employed to manage interstitial lung disease seen with trastuzumab deruxtecan?
Can patients be re-challenged after developing ILD? Is the toxicity seen with T-Dxd a potential barrier to use?
Do you feel the dosing used in NSCLC should be adjusted (such as using breast cancer dose) to help mitigate toxicity?
Answer from: Medical Oncologist at Academic Institution
Educating clinic staff and patients/family members is key. Any reports of worsening respiratory symptoms such as worsening cough or SOB should be carefully worked up and managed. Always check for saturation at clinic visits and (actively) look for interstitial findings at every scan (the patient cou...
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Answer from: Medical Oncologist at Academic Institution
A lower dose, as used in breast cancer should be considered. I would not re-challenge a patient who has developed ILD to previous trastuzumab deruxtecan. If, on the other hand, the patient has recovered from checkpoint inhibitor pneumonitis, I would consider using this agent at the lower dose. This ...