SynthesisCancer2026
The safety of trastuzumab deruxtecan (T-DXd) in breast cancer brain metastases with a focus on interstitial lung disease/pneumonitis: A systematic review and meta-analysis.
Synthesis in Cancer, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.
What it found
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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
1 citing paper in PubMed, 1 synthesis or guideline pooled it.
- Pooled it
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
Abstract
backgroundAlthough trastuzumab deruxtecan (T-DXd) demonstrated unprecedented intracranial efficacy in HER2-positive breast cancer brain metastases (BCBM), its association with interstitial lung disease (ILD)/pneumonitis posed a critical safety concern in this high-risk population. Previous safety assessments lacked BCBM-specific analysis of ILD.
methodsThis systematic review and meta-analysis (PROSPERO identifier CRD420251130832) followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The authors searched the PubMed, Embase, Web of Science, and Cochrane databases and major oncology conferences through July 2025 for studies that reported T-DXd-related, treatment-emergent adverse events (TEAEs) in patients with HER2-positive BCBM, focusing on ILD/pneumonitis incidence and severity. Pooled rates were calculated using random effects models.
resultsIn total, nine studies involving 684 patients with BCBM were included. The pooled incidence rates for all-grade and grade ≥3 ILD/pneumonitis were 10% (95% confidence interval [CI], 5%-16%) and 2% (95% CI, 1%-4%), respectively. ILD/pneumonitis led to discontinuation in 11% (95% CI, 0%-24%) of patients with BCBM. No fatal ILD events were reported. Overall, any-grade TEAEs occurred in 97% of patients, with grade ≥3 TEAEs occurring in 48%. Fatigue and nausea were the most prevalent all-grade TEAEs, with incidences of 67% and 60%, respectively.
conclusionsIn patients with BCBM, T-DXd-associated ILD/pneumonitis occurred in 10% of patient and frequently necessitated treatment modification. Although no fatal ILD was observed, the high discontinuation rate underscored the imperative for vigilant monitoring and protocol-guided management to mitigate pulmonary toxicity while preserving intracranial efficacy.
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