Optimizing Treatment Management of Trastuzumab Deruxtecan in Clinical Practice of Breast Cancer

The document reviews the management of adverse events (AEs) associated with trastuzumab deruxtecan (T-DXd) in breast cancer treatment, highlighting its efficacy in HER2-positive and HER2-low metastatic breast cancer. Key findings from the DESTINY-Breast01 and DESTINY-Breast03 trials show T-DXd's superiority over trastuzumab emtansine (T-DM1) in progression-free survival and overall response rate. Common AEs include nausea, vomiting, neutropenia, and interstitial lung disease (ILD), with nausea occurring in 72.8% of patients in the DESTINY-Breast03 trial. Proper management, including prophylaxis, monitoring, and individualized antiemetic regimens, is crucial to optimize treatment effectiveness and minimize serious AEs. The document emphasizes the importance of proactive monitoring and management of ILD/pneumonitis and cardiac issues, with recommendations for dose adjustments and supportive care to enhance patient outcomes.