Dr. Wei on the Risk of ILD With Trastuzumab Deruxtecan in HER2+ Breast Cancer

Mei Wei, MD, an internal medicine specialist at the University of Utah Health, discusses the risk of interstitial lung disease (ILD) with fam-trastuzumab deruxtecan-nxki (Enhertu) in HER2-positive breast cancer.

Without effective intervention strategies to manage ILD, the toxicity could limit the utility of trastuzumab deruxtecan in patients with HER2-positive breast cancer, says Wei. Moreover, some patients develop ILD from prior ado-trastuzumab emtansine (T-DM1; Kadcyla), which renders them ineligible for trastuzumab deruxtecan, Wei adds. Although the guidelines on managing ILD in this patient population are not clear, patients who develop treatment-related ILD should discontinue trastuzumab deruxtecan, explains Wei.

Moreover, ILD could limit the utility of trastuzumab deruxtecan in the neoadjuvant or adjuvant settings where the goal of treatment is cure, Wei says. If patients are at risk of dying from ILD and other effective options that are better tolerated are available, it is unlikely that trastuzumab deruxtecan will be widely adopted in the localized setting, concludes Wei.