SynthesisESMO open2023
Incidence of interstitial lung disease and cardiotoxicity with trastuzumab deruxtecan in breast cancer patients: a systematic review and single-arm meta-analysis.
Synthesis in ESMO open, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 50 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
50 citing papers in PubMed, 3 syntheses or guidelines pooled it, 54 citations in OpenAlex.
- Pooled it
- Pooled it
- Trastuzumab Deruxtecan-Induced Interstitial Lung Disease: A Systematic Review and Meta-Analysis of Clinical Trials and Real-World Evidence.Cancer control : journal of the Moffitt Cancer CenterPooled it
- MicroRNAs and Alarmins in Cardio-Oncology: Biomarkers and Therapeutic Implications in Skin and Breast Cancer.International journal of molecular sciences · 2026Review
- Interstitial Lung Disease and Cardiotoxicity Associated with Trastuzumab Deruxtecan, Sacituzumab Govitecan, and Trastuzumab Emtansine: A Narrative Review.Medicina (Kaunas, Lithuania) · 2026Review
- Cardio-Oncology in Cold Climates: Epidemiological Features, Bidirectional Interaction Mechanisms, and Integrated Management Strategies.Cardiovascular toxicology · 2026Review
- Cardiovascular Toxicity of Antibody-Drug Conjugates in Breast Cancer: Current Evidence and Evolving Considerations: JACC: CardioOncology Primer.JACC. CardioOncology · 2026Review
- Pharmacovigilance assessment of vinorelbine-associated adverse events using FAERS and VigiBase.Medicine · 2026Article
- Pharmacovigilance study and development of a clinical decision flowchart for personalized selection of trastuzumab, T-DXd, and T-DM1 in breast cancer patients.Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2026Article
- Development of a translational murine model for antibody-drug conjugate-induced interstitial lung disease.NPJ precision oncology · 2026Article
- Cardiotoxicity of monoclonal antibody-based therapies in breast cancer: a contemporary narrative review.Cardio-oncology (London, England) · 2026Review
- Article
- Narrative review of the similarities and differences between immune checkpoint inhibitor- and antibody-drug conjugate-associated pneumonitis.Translational lung cancer research · 2026Review
- Real-world analysis of interstitial lung disease/pneumonitis in Japanese patients with breast cancer receiving trastuzumab deruxtecan.Breast cancer (Tokyo, Japan) · 2026Observational
- Effectiveness of sacituzumab govitecan in metastatic triple-negative breast cancer: a real-world retrospective cohort study from Central Europe.The oncologist · 2026Article
- Mining and analysis of adverse events for trastuzumab deruxtecan based on the FAERS database.Frontiers in oncology · 2026Article
- Management of toxicities from antibody - drug conjugates in breast cancer.Frontiers in oncology · 2026Review
- Antineoplastic agent-associated interstitial lung disease in breast, ovarian, and prostate cancers: a pharmacovigilance study using the FDA adverse event reporting system.Frontiers in immunology · 2026Article
- Case Report: Persistent severe thrombocytopenia after adjuvant ado-trastuzumab emtansine with sequential bone marrow findings and romiplostim support.Frontiers in oncology · 2026Article
- Comparative effectiveness and safety of adjuvant trastuzumab plus pertuzumab versus trastuzumab emtansine in HER2-positive breast cancer with residual disease after neoadjuvant therapy: a real-world retrospective study.Frontiers in oncology · 2026Article
Corrections and comments
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Authors and funding
6 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundTrastuzumab deruxtecan (T-DXd) has been shown to benefit progression-free survival and overall survival in patients with metastatic breast cancer (mBC) after progression on ≥1 human epidermal growth factor receptor 2 (HER2)-targeted therapies. However, interstitial lung disease (ILD) and cardiotoxicity are the most significant toxicities associated with T-DXd. Therefore, we conducted a systematic review and meta-analysis to assess the incidence and severity of these toxicities in mBC patients treated with T-DXd. MATERIALS AND
methodsWe searched PubMed, Cochrane, and Scopus databases, and conferences websites for randomized clinical trials and nonrandomized studies of intervention including HER2-low or HER2-positive mBC patients who received at least one dose of T-DXd. Statistical analysis was carried out using R software.
resultsWe included 15 studies comprising 1970 patients with a mean follow-up of 13.3 months. Median age ranged from 53 to 59 years, 61.9% were non-Asian, and 67.4% had hormone receptor-positive mBC. In a pooled analysis, the incidence of ILD was 11.7% [222 patients; 95% confidence interval (CI) 9.1% to 15.0%]. Patients receiving T-DXd dose of 6.4 mg/kg developed a significantly higher rate of ILD (22.7%) compared to those receiving a dose of 5.4 mg/kg (9.3%) (P < 0.01). Most cases of ILD (80.2%; 174/217 patients) were mild (grade 1 or 2). Grade 3 or 4 ILD was reported in 29 patients (13.4%), and grade 5 in 14 patients (6.4%). The incidence of decreased left ventricular ejection fraction (LVEF) was 1.95% (95% CI 0.65% to 3.73%), and the QT interval (QTi) prolongation was 7.77% (95% CI 2.74% to 20.11%). Most patients were asymptomatic, but four had LV dysfunction and heart failure (0.26%).
conclusionsIn this meta-analysis of 1970 patients with mBC, treatment with T-DXd was associated with a 11.7% incidence of ILD, 7.7% incidence of prolonged QTi, and 1.9% incidence of reduced LVEF. Early detection and management of T-DXd-related toxicity by a multidisciplinary team may ultimately improve patient outcomes.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.