Evidence map›Paper›PMID 42768463›Full record

ArticleThe oncologist2026

Oral toxicities secondary to TROP2 and HER2-directed antibody drug conjugates: a multicenter retrospective cohort study.

Paolo J Fantozzi, Stephen Sonis, Andrea Botticelli, Simone Scagnoli, Monica Verrico, Giulia Bianchini, Maria Vittoria Bonomo, Chiara Bonadonna, Mathilde Casagrande, Lucia Borghetti and 5 more

Abstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in The oncologist, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

What it found

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2 · The registry

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

15 authors.

Paolo J FantozziDepartment of Oral and Maxillofacial Sciences, Sapienza University of Rome, Rome, 00187, Italy.ORCID 0000-0002-6807-3391
Stephen SonisDivisions of Oral Medicine and Dentistry, Brigham and Women's Hospital and the Dana-Farber Cancer Institute, Boston, MA 02115, United States.
Andrea BotticelliDepartment of Radiological, Pathological and Oncological Sciences, Umberto I/Sapienza University Hospital, Rome, 00187, Italy.ORCID 0000-0002-6425-9893
Simone ScagnoliDepartment of Radiological, Pathological and Oncological Sciences, Umberto I/Sapienza University Hospital, Rome, 00187, Italy.ORCID 0000-0003-4943-5622
Monica VerricoMedical Oncology Unit, Umberto I/Sapienza University Hospital, Rome, 00187, Italy.ORCID 0000-0002-2620-3047
Giulia BianchiniDepartment of Radiological, Pathological and Oncological Sciences, Umberto I/Sapienza University Hospital, Rome, 00187, Italy.
Maria Vittoria BonomoDepartment of Radiological, Pathological and Oncological Sciences, Umberto I/Sapienza University Hospital, Rome, 00187, Italy.ORCID 0009-0005-0416-0292
Chiara BonadonnaDepartment of Radiological, Pathological and Oncological Sciences, Umberto I/Sapienza University Hospital, Rome, 00187, Italy.
Mathilde CasagrandeDepartment of Oral and Maxillofacial Sciences, Sapienza University of Rome, Rome, 00187, Italy.
Lucia BorghettiDepartment of Oral and Maxillofacial Sciences, Sapienza University of Rome, Rome, 00187, Italy.ORCID 0009-0004-4017-4264
Gianluca TenoreDepartment of Oral and Maxillofacial Sciences, Sapienza University of Rome, Rome, 00187, Italy.
Sankalp DasT&D-Artificial Intelligence and Machine Learning, Baptist Health South Florida, Miami, FL 33176, United States.
John P DiazDepartment of Obstetrics and Gynecology, Florida International University College of Medicine, Miami, FL 33176, United States.
Umberto RomeoDepartment of Oral and Maxillofacial Sciences, Sapienza University of Rome, Rome, 00187, Italy.
Alessandro VillaDepartment of Orofacial Sciences, University of California San Francisco, San Francisco, CA 94143, United States.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThe aim of this multicenter retrospective cohort study was to characterize the incidence, clinical presentation, timing, severity, and management of oral toxicities (OTs) associated with TROP2-directed (datopotamab deruxtecan and sacituzumab govitecan) and HER2-directed (trastuzumab deruxtecan) antibody-drug conjugates in patients with advanced-stage cancers.

methodsA retrospective medical-records review of 207 patients was conducted to characterize antibody-drug conjugate (ADC)-associated OTs. Patients had been treated for advanced-stage cancers treated with TROP2 (sacituzumab govitecan and datopotamab deruxtecan) and HER2-directed ADCs (trastuzumab deruxtecan) at the Sapienza University-Hospital and Miami Cancer Institute between 2024 and 2025. Multivariate logistic regressions were performed to evaluate any correlation between the ADC type and prevalence, type, severity, time of onset, and time to resolution of OTs.

resultsOverall, 47 patients (22.7%) developed OTs, with a median onset time of 7.5 days (range: 1-358). The OT prevalence was similar between TROP2 (n = 27, 23.5%) and HER2-directed (n = 20, 21.7%) ADCs, however, oral mucositis (OM) was more frequent with TROP2-directed ADCs (14.8% vs 5.4%, P = .04), whereas xerostomia (10.9% vs 6.1%, P = .31) and dysgeusia (9.8% vs 5.2%, P = .28) were more common and more severe with HER2-directed ADCs, although not reaching statistical significance. Patients receiving TROP2-directed ADCs had a 3.02-fold higher-risk of developing OM compared to those receiving HER2-directed ADCs (95% CI: 1.07-8.52, P = .040). In cases of OM, the trajectory of TROP2-associated OM was more acute than with HER-2-associated OM with earlier onset (P = .035) and quicker resolution (P = .045). Management of OTs was provided for 29 (14.0%) patients with the majority of them receiving TROP2-directed ADCs (n = 21, 17.3%). With regard to OTs, patients developing OM were associated with a greater need for management (n = 19/22; P = .001), compared to xerostomia (n = 8/17; P = .471) and dysgeusia (n = 2/15; P = .196). Ultimately, ADC dose reduction (DR) was required in 43 patients (20.8%) and was significantly more frequent with TROP2-directed ADCs (26.1% vs 14.1%, P = .039).

conclusionTROP2-directed ADCs are associated with a higher-risk of OM (P = .040) with earlier onset of toxicities (P = .035), and greater DR requirements (P = .039). In contrast, HER2-directed ADCs are associated with more prevalent xerostomia and dysgeusia, a higher overall severity, and later onset but potentially longer duration.

Indexed as

Antigens, NeoplasmCell Adhesion MoleculesErb-b2 Receptor Tyrosine KinasesImmunoconjugatesNeoplasmsAdultAgedAged, 80 and overAntibodies, Monoclonal, HumanizedBridged Bicyclo Compounds, HeterocyclicCamptothecinCohort StudiesFemaleHumansMaleMiddle AgedAntibodies, Monoclonal, HumanizedAntigens, NeoplasmBridged Bicyclo Compounds, HeterocyclicCamptothecinCell Adhesion MoleculesERBB2 protein, humanErb-b2 Receptor Tyrosine KinasesImmunoconjugatessacituzumab govitecanTACSTD2 protein, humanTrastuzumabantibody drug conjugatesdatopotamab deruxtecandysgeusiaoral medicineoral mucositisoral oncologysacituzumab govitecantrastuzumab deruxtecanxerostomia

Identifiers

PMID42768463
PMCPMC13616048

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