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- Title
Clinical and imaging features of interstitial lung disease in cancer patients treated with trastuzumab deruxtecan.
- Authors
Baba, Tomohisa; Kusumoto, Masahiko; Kato, Terufumi; Kurihara, Yasuyuki; Sasaki, Shinichi; Oikado, Katsunori; Saito, Yoshinobu; Endo, Masahiro; Fujiwara, Yutaka; Kenmotsu, Hirotsugu; Sata, Masafumi; Takano, Toshimi; Kato, Ken; Hirata, Koji; Katagiri, Tomomi; Saito, Hanako; Kuwano, Kazuyoshi
- Abstract
Background: Interstitial lung disease/pneumonitis (ILD/pneumonitis) has been identified as a drug-related adverse event of special interest of trastuzumab deruxtecan (T-DXd), but there were a few reports of T-DXd-related ILD/pneumonitis in clinical practice. Methods: Between May 25, 2020 (the launch of T-DXd in Japan) and February 24, 2022, there were 287 physician-reported potential ILD/pneumonitis cases from the Japanese post-marketing all-case surveillance. By February 27, 2022, an independent adjudication committee assessed 138 cases and adjudicated 130 cases as T-DXd-related ILD/pneumonitis. The clinical features and imaging characteristics of these cases were evaluated. Results: The majority of adjudicated T-DXd-related ILD/pneumonitis cases were grade 1 or 2 (100/130, 76.9%). The most common radiological pattern types observed were organizing pneumonia patterns (63.1%), hypersensitivity pneumonitis patterns (16.9%), and diffuse alveolar damage (DAD) patterns (14.6%). Eleven cases (8.5%) from 130 resulted in death; the majority of these (8/11, 72.7%) had DAD patterns. The overall proportion of recovery (including the outcomes of recovered, recovered with sequelae, and recovering) was 76.9%, and the median time to recovery was 83.5 days (interquartile range: 42.25–143.75 days). Most cases (59/71, 83.1%) that were treated with corticosteroids were considered responsive to treatment. Conclusions: This is the first report to evaluate T-DXd-related ILD/pneumonitis cases in clinical practice. Our findings are consistent with previous reports and suggest that patients with DAD patterns have poor outcomes. Evaluation of a larger real-world dataset may further identify predictors of clinical outcome.
- Subjects
JAPAN; INTERSTITIAL lung diseases; LUNG cancer; HYPERSENSITIVITY pneumonitis; TRASTUZUMAB; DIAGNOSTIC imaging; ORGANIZING pneumonia
- Publication
International Journal of Clinical Oncology, 2023, Vol 28, Issue 12, p1585
- ISSN
1341-9625
- Publication type
Article
- DOI
10.1007/s10147-023-02414-x