Strategies to Manage Antibody Drug Conjugates (ADC) - Related Toxicities in Breast Cancer - Episode 9

Expert Perspectives: T-DM1 Adverse Events Overview and Management Strategies

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Panelists discuss how management and monitoring for pneumonitis and cardiotoxicity in trastuzumab deruxtecan (T-DXd) is similar to trastuzumab emtansine (T-DM1), while also emphasizing the need for awareness of adverse effects such as peripheral neuropathy, thrombocytopenia, and hepatotoxicity, along with strategies for their management and when to consider therapy modifications.

Video content above is prompted by the following:

In terms of pneumonitis and cardiotoxicity, is your management and monitoring relatively the same to trastuzumab deruxtecan (T-DXd)?

  • What other pertinent adverse effects (AEs) of trastuzumab emtansine (T-DM1) should practicing oncologists be aware of?
  1. Peripheral neuropathy
  2. Thrombocytopenia
  3. Aspartate aminotransferase/alanine aminotransferase elevations
  • Let’s dive deeper into managing some of these T-DM1–related AEs; how do you manage the following:
  1. Peripheral neuropathy
  2. Thrombocytopenia: When do you delay/hold/discontinue therapy?
  3. Hepatotoxicity: When do you delay/hold/discontinue therapy?

Please comment on any other treatment-resistant AEs with T-DM1 seen in your clinical practice.