Evaluating risk factors for Trastuzumab-Deruxtecan Pneumonitis in patients with metastatic breast cancer
Abstract Background Trastuzumab deruxtecan (T-DXd) is FDA-approved for treatment of patients with HER2 positive and HER2-low metastatic breast cancer. Currently, there is limited understanding of pre-treatment risk factors for pneumonitis associated with T-DXd. Methods Consecutive breast cancer pati...
Saved in:
| Main Authors: | , , , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2025-02-01
|
| Series: | Breast Cancer Research |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13058-025-01967-1 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1823861474449162240 |
|---|---|
| author | Jonathan Henricks Tyler Haddad Omair Ahmed Jonathan Schoenhals Pavnesh Kumar Ryan Wilson Jianing Ma Jing Gennie Wang Michael Wert Vincent Esguerra Ian Bentley Kai Johnson Daniel Stover Sachin R. Jhawar Margaret Gatti-Mays Kevin Ho |
| author_facet | Jonathan Henricks Tyler Haddad Omair Ahmed Jonathan Schoenhals Pavnesh Kumar Ryan Wilson Jianing Ma Jing Gennie Wang Michael Wert Vincent Esguerra Ian Bentley Kai Johnson Daniel Stover Sachin R. Jhawar Margaret Gatti-Mays Kevin Ho |
| author_sort | Jonathan Henricks |
| collection | DOAJ |
| description | Abstract Background Trastuzumab deruxtecan (T-DXd) is FDA-approved for treatment of patients with HER2 positive and HER2-low metastatic breast cancer. Currently, there is limited understanding of pre-treatment risk factors for pneumonitis associated with T-DXd. Methods Consecutive breast cancer patients who received at least one dose of T-DXd at a single academic cancer study between January 1, 2019, and February 20, 2024, were identified for analysis. Pneumonitis was documented by the treating oncologist at the time of toxicity and retrospectively independently confirmed by a member of the study team through chart and radiologic review. Pre-treatment variables of interest were collected, including patient demographics, radiation dosimetry variables, and chest imaging abnormalities. Results Of 179 total patients, 23 (12.8%) had pneumonitis after T-DXd exposure. Patients with pneumonitis had lower baseline oxygen saturation (98% vs. 97%, p = 0.02) and were more likely to have received abemaciclib (26.1% vs. 9.6%, p = 0.03) before T-DXd. Multiple pre-treatment variables were not found to be associated with T-DXd pneumonitis, including chest imaging abnormalities (41.9% vs. 47.8%, p = 0.59), prior immune checkpoint inhibitor treatment (16.0% vs. 8.7%, p = 0.50) and prior chest or breast radiation (61.5% vs. 47.8%, p = 0.20). On multivariate analysis, prior treatment with abemaciclib remained significantly associated with T-DXd pneumonitis (OR 3.25 [1.07–9.11], p = 0.04), while neither pre-treatment chest imaging abnormalities nor prior chest or breast radiation were associated (OR 1.60 [0.62–4.20], p = 0.33); OR 0.51 [0.20–1.33], p = 0.17). Conclusions In this cohort, prior treatment with abemaciclib may be a risk factor for T-DXd pneumonitis. Conversely, pre-treatment chest imaging abnormalities, prior immune checkpoint inhibitor treatment, and prior chest or breast radiation did not increase the risk of T-DXd pneumonitis. Larger studies are warranted to validate these findings toward an improved understanding of risk factors for pneumonitis after T-DXd exposure. |
| format | Article |
| id | doaj-art-6c5f29284a0f4779bc15493350b692d2 |
| institution | Kabale University |
| issn | 1465-542X |
| language | English |
| publishDate | 2025-02-01 |
| publisher | BMC |
| record_format | Article |
| series | Breast Cancer Research |
| spelling | doaj-art-6c5f29284a0f4779bc15493350b692d22025-02-09T13:00:44ZengBMCBreast Cancer Research1465-542X2025-02-012711810.1186/s13058-025-01967-1Evaluating risk factors for Trastuzumab-Deruxtecan Pneumonitis in patients with metastatic breast cancerJonathan Henricks0Tyler Haddad1Omair Ahmed2Jonathan Schoenhals3Pavnesh Kumar4Ryan Wilson5Jianing Ma6Jing Gennie Wang7Michael Wert8Vincent Esguerra9Ian Bentley10Kai Johnson11Daniel Stover12Sachin R. Jhawar13Margaret Gatti-Mays14Kevin Ho15Department of Internal Medicine, Ohio State UniversityDepartment of Pulmonary, Critical Care, and Sleep Medicine, Ohio State UniversityDepartment of Internal Medicine, Ohio State UniversityDepartment of Radiation Oncology, Ohio State UniversityDepartment of Radiation Oncology, Ohio State UniversityCollege of Medicine, Ohio State UniversityCenter for Biostatistics, Ohio State UniversityDepartment of Pulmonary, Critical Care, and Sleep Medicine, Ohio State UniversityDepartment of Pulmonary, Critical Care, and Sleep Medicine, Ohio State UniversityDepartment of Pulmonary, Critical Care, and Sleep Medicine, Ohio State UniversityDepartment of Pulmonary, Critical Care, and Sleep Medicine, Ohio State UniversityDepartment of Oncology, Ohio State UniversityDepartment of Oncology, Ohio State UniversityDepartment of Radiation Oncology, Ohio State UniversityDepartment of Oncology, Ohio State UniversityDepartment of Pulmonary, Critical Care, and Sleep Medicine, Ohio State UniversityAbstract Background Trastuzumab deruxtecan (T-DXd) is FDA-approved for treatment of patients with HER2 positive and HER2-low metastatic breast cancer. Currently, there is limited understanding of pre-treatment risk factors for pneumonitis associated with T-DXd. Methods Consecutive breast cancer patients who received at least one dose of T-DXd at a single academic cancer study between January 1, 2019, and February 20, 2024, were identified for analysis. Pneumonitis was documented by the treating oncologist at the time of toxicity and retrospectively independently confirmed by a member of the study team through chart and radiologic review. Pre-treatment variables of interest were collected, including patient demographics, radiation dosimetry variables, and chest imaging abnormalities. Results Of 179 total patients, 23 (12.8%) had pneumonitis after T-DXd exposure. Patients with pneumonitis had lower baseline oxygen saturation (98% vs. 97%, p = 0.02) and were more likely to have received abemaciclib (26.1% vs. 9.6%, p = 0.03) before T-DXd. Multiple pre-treatment variables were not found to be associated with T-DXd pneumonitis, including chest imaging abnormalities (41.9% vs. 47.8%, p = 0.59), prior immune checkpoint inhibitor treatment (16.0% vs. 8.7%, p = 0.50) and prior chest or breast radiation (61.5% vs. 47.8%, p = 0.20). On multivariate analysis, prior treatment with abemaciclib remained significantly associated with T-DXd pneumonitis (OR 3.25 [1.07–9.11], p = 0.04), while neither pre-treatment chest imaging abnormalities nor prior chest or breast radiation were associated (OR 1.60 [0.62–4.20], p = 0.33); OR 0.51 [0.20–1.33], p = 0.17). Conclusions In this cohort, prior treatment with abemaciclib may be a risk factor for T-DXd pneumonitis. Conversely, pre-treatment chest imaging abnormalities, prior immune checkpoint inhibitor treatment, and prior chest or breast radiation did not increase the risk of T-DXd pneumonitis. Larger studies are warranted to validate these findings toward an improved understanding of risk factors for pneumonitis after T-DXd exposure.https://doi.org/10.1186/s13058-025-01967-1Trastuzumab-DeruxtecanPneumonitisBreast cancer |
| spellingShingle | Jonathan Henricks Tyler Haddad Omair Ahmed Jonathan Schoenhals Pavnesh Kumar Ryan Wilson Jianing Ma Jing Gennie Wang Michael Wert Vincent Esguerra Ian Bentley Kai Johnson Daniel Stover Sachin R. Jhawar Margaret Gatti-Mays Kevin Ho Evaluating risk factors for Trastuzumab-Deruxtecan Pneumonitis in patients with metastatic breast cancer Breast Cancer Research Trastuzumab-Deruxtecan Pneumonitis Breast cancer |
| title | Evaluating risk factors for Trastuzumab-Deruxtecan Pneumonitis in patients with metastatic breast cancer |
| title_full | Evaluating risk factors for Trastuzumab-Deruxtecan Pneumonitis in patients with metastatic breast cancer |
| title_fullStr | Evaluating risk factors for Trastuzumab-Deruxtecan Pneumonitis in patients with metastatic breast cancer |
| title_full_unstemmed | Evaluating risk factors for Trastuzumab-Deruxtecan Pneumonitis in patients with metastatic breast cancer |
| title_short | Evaluating risk factors for Trastuzumab-Deruxtecan Pneumonitis in patients with metastatic breast cancer |
| title_sort | evaluating risk factors for trastuzumab deruxtecan pneumonitis in patients with metastatic breast cancer |
| topic | Trastuzumab-Deruxtecan Pneumonitis Breast cancer |
| url | https://doi.org/10.1186/s13058-025-01967-1 |
| work_keys_str_mv | AT jonathanhenricks evaluatingriskfactorsfortrastuzumabderuxtecanpneumonitisinpatientswithmetastaticbreastcancer AT tylerhaddad evaluatingriskfactorsfortrastuzumabderuxtecanpneumonitisinpatientswithmetastaticbreastcancer AT omairahmed evaluatingriskfactorsfortrastuzumabderuxtecanpneumonitisinpatientswithmetastaticbreastcancer AT jonathanschoenhals evaluatingriskfactorsfortrastuzumabderuxtecanpneumonitisinpatientswithmetastaticbreastcancer AT pavneshkumar evaluatingriskfactorsfortrastuzumabderuxtecanpneumonitisinpatientswithmetastaticbreastcancer AT ryanwilson evaluatingriskfactorsfortrastuzumabderuxtecanpneumonitisinpatientswithmetastaticbreastcancer AT jianingma evaluatingriskfactorsfortrastuzumabderuxtecanpneumonitisinpatientswithmetastaticbreastcancer AT jinggenniewang evaluatingriskfactorsfortrastuzumabderuxtecanpneumonitisinpatientswithmetastaticbreastcancer AT michaelwert evaluatingriskfactorsfortrastuzumabderuxtecanpneumonitisinpatientswithmetastaticbreastcancer AT vincentesguerra evaluatingriskfactorsfortrastuzumabderuxtecanpneumonitisinpatientswithmetastaticbreastcancer AT ianbentley evaluatingriskfactorsfortrastuzumabderuxtecanpneumonitisinpatientswithmetastaticbreastcancer AT kaijohnson evaluatingriskfactorsfortrastuzumabderuxtecanpneumonitisinpatientswithmetastaticbreastcancer AT danielstover evaluatingriskfactorsfortrastuzumabderuxtecanpneumonitisinpatientswithmetastaticbreastcancer AT sachinrjhawar evaluatingriskfactorsfortrastuzumabderuxtecanpneumonitisinpatientswithmetastaticbreastcancer AT margaretgattimays evaluatingriskfactorsfortrastuzumabderuxtecanpneumonitisinpatientswithmetastaticbreastcancer AT kevinho evaluatingriskfactorsfortrastuzumabderuxtecanpneumonitisinpatientswithmetastaticbreastcancer |