HER2+ Breast Cancer: Trastuzumab Deruxtecan Retreatment Options
- Trastuzumab deruxtecan, an antibody-drug conjugate, has emerged as a significant treatment for HER2-positive breast cancer.
- Current guidelines recommend discontinuing trastuzumab deruxtecan for patients who develop grade 2 ILD.
- Rugo, MD, division chief of breast medical oncology at city of Hope, presented real-world evidence from five institutions (2017-2024) at the American Society of Clinical Oncology annual meeting...
Confront HER2+ breast cancer with informed decisions. This report analyzes key findings on trastuzumab deruxtecan retreatment options with critical insights for managing interstitial lung disease (ILD), a meaningful side effect. Discover how early steroid intervention dramatically cuts ILD recovery time, a crucial element for patients. Following guidelines, learn the six-week protocol for restarting treatment after grade 1 ILD, and understand why moving trastuzumab deruxtecan to earlier stages requires extra caution. News Directory 3 provides patients and medical professionals with the latest updates. Explore new research and updated protocols on breast cancer in this comprehensive analysis. Discover what’s next concerning ILD management and treatment strategies.
Managing Interstitial Lung Disease with Trastuzumab Deruxtecan in Breast Cancer Treatment
Trastuzumab deruxtecan, an antibody-drug conjugate, has emerged as a significant treatment for HER2-positive breast cancer. However,its use is complex by the risk of interstitial lung disease,a perhaps fatal side effect.
Current guidelines recommend discontinuing trastuzumab deruxtecan for patients who develop grade 2 ILD. While retreatment is possible for those with grade 1 ILD, limited data existed on patient outcomes after restarting the medication. Recent research is providing insights into this area.
Hope S. Rugo, MD, division chief of breast medical oncology at city of Hope, presented real-world evidence from five institutions (2017-2024) at the American Society of Clinical Oncology annual meeting on May 30, 2025.The study examined outcomes of patients who were retreated with trastuzumab deruxtecan after recovering from ILD.Preliminary data had been shared at the European Society for Medical Oncology meeting in 2024.
The research indicated no significant differences in demographics, time to ILD onset, rechallenge timing, or recurrent ILD among patients. A key finding highlighted the importance of early steroid use, which reduced recovery time by more then half compared to patients who did not receive steroids.
Rugo outlined a specific protocol for managing grade 1 ILD to facilitate a swift return to therapy. “If the scan shows grade 1 ILD, you start the steroids [and] skip that dose. Then, 3 weeks later, you’ll want to have another scan so that you can get the next treatment on schedule.” This approach results in a six-week interval between doses.
Despite the inclusion of grade 2 ILD cases in the study, Rugo does not advocate for changes to current guidelines. She emphasized the need for caution, stating, ”We need to be ultra safe,” particularly when determining if grade 2 ILD is drug-related. Rugo noted that while trastuzumab deruxtecan is a highly effective ADC, other effective options exist.
Rugo stressed vigilance, especially considering the DESTINY-Breast09 trial results. “As we move the drugs earlier into the course of treatment, we definitely do not want to shorten life or cause significant disability,” she said.
What’s next
Ongoing research will likely focus on refining ILD management strategies and identifying predictive factors for its progress, ensuring safer and more effective use of trastuzumab deruxtecan in earlier lines of breast cancer treatment.