Use and management of Trastuzumab Deruxtecan in people with breast cancer: recommendations

Authors

DOI:

https://doi.org/10.31877/on.2024.49.05

Keywords:

Trastuzumab deruxtecan, Breast, Cancer, Recommendation, Nurses

Abstract

Trastuzumab Deruxtecan is indicated for the treatment of Human Epidermal growth factor Receptor-type 2 HER2-positive or HER2-low breast cancer, showing favorable efficacy and safety profiles. However, it can lead to some severe adverse events, such as interstitial lung disease.

We performed four regional experience sharing sessions and one final national discussion session, with the participation of several nurses from different Portuguese hospitals and two “Associação de Enfermagem Oncológica Portuguesa” representatives. The purpose of this document is to develop broad national recommendations for nurse practice, to standardize the administration and management of adverse events related to Trastuzumab Deruxtecan.

It is essential to raise awareness among patients to report any signs and symptoms during treatment with Trastuzumab Deruxtecan. Immediate action with the recommendations herein may avoid complications that lead to drug discontinuation and/or serious outcomes.

Downloads

Download data is not yet available.

References

Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, et al. Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA Cancer J Clin. 2021;71(3):209–49.

Cancer IA for R on. Breast Cancer Fact Sheet [Internet]. CANCER TODAY. Cham; 2020 [cited 2024 Jan 13]. Available from: https://gco.iarc.fr/today/data/factsheets/cancers/20-Breast-fact-sheet.pdf

Iqbal N, Iqbal N. Human Epidermal Growth Factor Receptor 2 (HER2) in Cancers: Overexpression and Therapeutic Implications. Mol Biol Int. 2014;2014:1–9.

Slamon DJ, Clark GM, Wong SG, Levin WJ, Ullrich A, McGuire WL. Human Breast Cancer: Correlation of Relapse and Survival with Amplification of the HER-2/ neu Oncogene. Science (80- ) [Internet]. 1987 Jan 9;235(4785):177–82. Available from: https://www.science.org/doi/10.1126/science.3798106

Burstein HJ. The Distinctive Nature of HER2-Positive Breast Cancers. N Engl J Med [Internet]. 2005 Oct 20;353(16):1652–4. Available from: http://www.nejm.org/doi/abs/10.1056/NEJMp058197

Chung C, Yeung VTY, Wong KCW. Prognostic and predictive biomarkers with therapeutic targets in breast cancer: A 2022 update on current developments, evidence, and recommendations. J Oncol Pharm Pract [Internet]. 2023 Sep 15;29(6):1343–60. Available from: http://journals.sagepub.com/doi/10.1177/10781552221119797

Marchiò C, Annaratone L, Marques A, Casorzo L, Berrino E, Sapino A. Evolving concepts in HER2 evaluation in breast cancer: Heterogeneity, HER2-low carcinomas and beyond. Semin Cancer Biol [Internet]. 2021 Jul;72(February):123–35. Available from: https://doi.org/10.1016/j.semcancer.2020.02.016

Slavcheva SE, Angelov A. HER2-Targeted Therapy—From Pathophysiology to Clinical Manifestation: A Narrative Review. J Cardiovasc Dev Dis [Internet]. 2023 Dec 6;10(12):489. Available from: https://www.mdpi.com/2308-3425/10/12/489

Ivanova M, Porta FM, D’Ercole M, Pescia C, Sajjadi E, Cursano G, et al. Standardized pathology report for HER2 testing in compliance with 2023 ASCO/CAP updates and 2023 ESMO consensus statements on HER2-low breast cancer. Virchows Arch [Internet]. 2023 Sep 28;(0123456789). Available from: https://doi.org/10.1007/s00428-023-03656-w

Ahn S, Woo JW, Lee K, Park SY. HER2 status in breast cancer: changes in guidelines and complicating factors for interpretation. J Pathol Transl Med [Internet]. 2020 Jan 15;54(1):34–44. Available from: http://jpatholtm.org/journal/view.php?doi=10.4132/jptm.2019.11.03

Miglietta F, Griguolo G, Bottosso M, Giarratano T, Lo Mele M, Fassan M, et al. Evolution of HER2-low expression from primary to recurrent breast cancer. npj Breast Cancer [Internet]. 2021 Oct 12;7(1):137. Available from: https://www.nature.com/articles/s41523-021-00343-4

Matutino A, Joy AA, Brezden-Masley C, Chia S, Verma S. Hormone Receptor–Positive, HER2-Negative Metastatic Breast Cancer: Redrawing the Lines. Curr Oncol [Internet]. 2018 Jun 1;25(11):131–41. Available from: https://www.mdpi.com/1718-7729/25/11/4000

Obidiro O, Battogtokh G, Akala EO. Triple Negative Breast Cancer Treatment Options and Limitations: Future Outlook. Pharmaceutics [Internet]. 2023 Jun 23;15(7):1796. Available from: https://www.mdpi.com/1999-4923/15/7/1796

Harbeck N, Gnant M. Breast cancer. Lancet [Internet]. 2017;389(10074):1134–50. Available from: http://dx.doi.org/10.1016/S0140-6736(16)31891-8

Schettini F, Chic N, Brasó-Maristany F, Paré L, Pascual T, Conte B, et al. Clinical, pathological, and PAM50 gene expression features of HER2-low breast cancer. npj Breast Cancer [Internet]. 2021 Jan 4;7(1):1. Available from: https://www.nature.com/articles/s41523-020-00208-2

Tarantino P, Hamilton E, Tolaney SM, Cortes J, Morganti S, Ferraro E, et al. HER2-Low Breast Cancer: Pathological and Clinical Landscape. J Clin Oncol [Internet]. 2020 Jun 10;38(17):1951–62. Available from: https://ascopubs.org/doi/10.1200/JCO.19.02488

Modi S, Jacot W, Yamashita T, Sohn J, Vidal M, Tokunaga E, et al. Trastuzumab Deruxtecan in Previously Treated HER2-Low Advanced Breast Cancer. N Engl J Med [Internet]. 2022 Jul 7;387(1):9–20. Available from: http://www.nejm.org/doi/10.1056/NEJMoa2203690

European Medicines Agency. Anexo I - Resumo Das Características Do Medicamento [Internet]. Enhertu: Trastuzumab Deruxtecano. 2022 [cited 2024 Jan 13]. Available from: https://www.ema.europa.eu/pt/documents/product-information/enhertu-epar-product-information_pt.pdf

Nakada T, Sugihara K, Jikoh T, Abe Y, Agatsuma T. The Latest Research and Development into the Antibody–Drug Conjugate, [fam-] Trastuzumab Deruxtecan (DS-8201a), for HER2 Cancer Therapy. Chem Pharm Bull [Internet]. 2019 Mar 1;67(3):173–85. Available from: https://www.jstage.jst.go.jp/article/cpb/67/3/67_c18-00744/_article

Ogitani Y, Aida T, Hagihara K, Yamaguchi J, Ishii C, Harada N, et al. DS-8201a, A Novel HER2-Targeting ADC with a Novel DNA Topoisomerase I Inhibitor, Demonstrates a Promising Antitumor Efficacy with Differentiation from T-DM1. Clin Cancer Res [Internet]. 2016 Oct 15;22(20):5097–108. Available from: https://aacrjournals.org/clincancerres/article/22/20/5097/124857/DS-8201a-A-Novel-HER2-Targeting-ADC-with-a-Novel

Xu Z, Guo D, Jiang Z, Tong R, Jiang P, Bai L, et al. Novel HER2-Targeting Antibody-Drug Conjugates of Trastuzumab Beyond T-DM1 in Breast Cancer: Trastuzumab Deruxtecan(DS-8201a) and (Vic-)Trastuzumab Duocarmazine (SYD985). Eur J Med Chem [Internet]. 2019 Dec;183:111682. Available from: https://doi.org/10.1016/j.ejmech.2019.111682

Mitani S, Kawakami H. Emerging Targeted Therapies for HER2 Positive Gastric Cancer That Can Overcome Trastuzumab Resistance. Cancers (Basel) [Internet]. 2020 Feb 10;12(2):400. Available from: https://www.mdpi.com/2072-6694/12/2/400

Boekhout AH, Beijnen JH, Schellens JHM. Trastuzumab. Oncologist [Internet]. 2011 Jun 1;16(6):800–10. Available from: http://journals.sagepub.com/doi/10.2217/17455057.1.2.161

Nagai Y, Oitate M, Shiozawa H, Ando O. Comprehensive preclinical pharmacokinetic evaluations of trastuzumab deruxtecan (DS-8201a), a HER2-targeting antibody-drug conjugate, in cynomolgus monkeys. Xenobiotica [Internet]. 2019;49(9):1086–96. Available from: https://doi.org/10.1080/00498254.2018.1531158

Doi T, Shitara K, Naito Y, Shimomura A, Fujiwara Y, Yonemori K, et al. Safety, pharmacokinetics, and antitumour activity of trastuzumab deruxtecan (DS-8201), a HER2-targeting antibody–drug conjugate, in patients with advanced breast and gastric or gastro-oesophageal tumours: a phase 1 dose-escalation study. Lancet Oncol [Internet]. 2017;18(11):1512–22. Available from: http://dx.doi.org/10.1016/S1470-2045(17)30604-6

National Center for Biotechnology Information. PubChem Compound Summary for , Trastuzumab Deruxtecan [Internet]. PubChem. 2004 [cited 2024 Jan 13]. Available from: https://pubchem.ncbi.nlm.nih.gov/compound/Trastuzumab-Deruxtecan

Meireles P, Magno S, Pereira dos Santos M. O uso de trastuzumab- deruxtecano na terapêutica do cancro da mama – da evidência à prática clínica. Focus em Cancro da mama. 2022;(TRASTUZUMAB DERUXTECAN):1–5.

Shitara K, Baba E, Fujitani K, Oki E, Fujii S, Yamaguchi K. Discovery and development of trastuzumab deruxtecan and safety management for patients with HER2-positive gastric cancer. Gastric Cancer [Internet]. 2021 Jul 16;24(4):780–9. Available from: https://doi.org/10.1007/s10120-021-01196-3

Tamura K, Tsurutani J, Takahashi S, Iwata H, Krop IE, Redfern C, et al. Trastuzumab deruxtecan (DS-8201a) in patients with advanced HER2-positive breast cancer previously treated with trastuzumab emtansine: a dose-expansion, phase 1 study. Lancet Oncol [Internet]. 2019 Jun;20(6):816–26. Available from: http://dx.doi.org/10.1016/S1470-2045(19)30097-X

Modi S, Saura C, Yamashita T, Park YH, Kim S-B, Tamura K, et al. Trastuzumab Deruxtecan in Previously Treated HER2-Positive Breast Cancer. N Engl J Med [Internet]. 2020 Feb 13;382(7):610–21. Available from: http://www.nejm.org/doi/10.1056/NEJMoa1914510

André F, Hee Park Y, Kim S-B, Takano T, Im S-A, Borges G, et al. Trastuzumab deruxtecan versus treatment of physician’s choice in patients with HER2-positive metastatic breast cancer (DESTINY-Breast02): a randomised, open-label, multicentre, phase 3 trial. Lancet [Internet]. 2023 May;401(10390):1773–85. Available from: https://linkinghub.elsevier.com/retrieve/pii/S0140673623007250

Cortés J, Kim S-B, Chung W-P, Im S-A, Park YH, Hegg R, et al. Trastuzumab Deruxtecan versus Trastuzumab Emtansine for Breast Cancer. N Engl J Med [Internet]. 2022 Mar 24;386(12):1143–54. Available from: http://www.nejm.org/doi/10.1056/NEJMoa2115022

Powell CA, Modi S, Iwata H, Takahashi S, Smit EF, Siena S, et al. Pooled analysis of drug-related interstitial lung disease and/or pneumonitis in nine trastuzumab deruxtecan monotherapy studies. ESMO Open [Internet]. 2022 Aug;7(4):100554. Available from: https://doi.org/10.1016/j.esmoop.2022.100554

Soares LR, Vilbert M, Rosa VDL, Oliveira JL, Deus MM, Freitas-Junior R. Incidence of interstitial lung disease and cardiotoxicity with trastuzumab deruxtecan in breast cancer patients: a systematic review and single-arm meta-analysis. ESMO Open [Internet]. 2023 Aug;8(4):101613. Available from: https://doi.org/10.1016/j.esmoop.2023.101613

Swain SM, Nishino M, Lancaster LH, Li BT, Nicholson AG, Bartholmai BJ, et al. Multidisciplinary clinical guidance on trastuzumab deruxtecan (T-DXd)–related interstitial lung disease/pneumonitis-Focus on proactive monitoring, diagnosis, and management. Cancer Treat Rev [Internet]. 2022 May;106(March):102378. Available from: https://doi.org/10.1016/j.ctrv.2022.102378.

Published

2024-10-23

How to Cite

1.
Amorim AP, Chemela AR, Cordeiro R, Freitas J, Góis C, Lamas B, Núñez V, Pedro S, Ponte S. Use and management of Trastuzumab Deruxtecan in people with breast cancer: recommendations. Onco.News [Internet]. 2024 Oct. 23 [cited 2024 Oct. 28];(49):e0264. Available from: https://onco.news/index.php/journal/article/view/264