Expert Expands on Side Effects Related to ADC Treatment in Breast Cancer

Antibody-drug conjugates (ADCs) represent an advancement in anticancer therapies, particularly in breast cancer. These agents selectively deliver toxic payloads directly to cancer cells, minimizing off-target effects and enhancing therapeutic efficacy. Currently, three ADCs have received FDA approval for the treatment of breast cancer: Kadcyla (ado-trastuzumab emtansine), followed by Enhertu (trastuzumab deruxtecan; T-DXd) and finally, Trodelvy (sacituzumab govitecan-hziy). Despite this pivotal advancement for patients, ADCs also offer unique toxicities which patients must be aware of when undergoing treatment, according to Dr. Aditya Bardia.

In an interview with CURE®, Bardia shared his insights on what he believes are the top side effects to be aware of when undergoing ADC treatment, as well as highlights how the timing of disease progression may impact the effectiveness of this treatment.

Bardia is a professor in the Department of Medicine, Division of Hematology/Oncology, director of Translational Research Integration, and a member Signal Transduction and Therapeutics, at University of California, Los Angeles (UCLA) Health Jonsson Comprehensive Cancer Center.

Transcript:

Important side effects with [Enhertu] includes nausea. For nausea, we generally recommend a three drug anti-nausea regimen before the patient starts [Enhertu] to prevent nausea, and if a patient is still having nausea despite then [Zyprexa (olanzapine)] usually is a good breakthrough medication.

The second side effect is decrease in counts such as white blood cells or hemoglobin, and for that, appropriate therapy, like a [red blood cell] transfusion, can be considered. The third side effect, which is rare but important, is pneumonitis, which is inflammation in the lungs. In any patient who's on [Enhertu] and has shortness of breath or cough, it's important to let the physician know, because that could be pneumonitis, which requires the use of steroids to treat this side effect.

[Furthermore, Enhertu] works regardless of the time to disease progression on first-line therapy, both in patients with rapid progression versus not. [Enhertu] works, so it is a regimen that could be considered whenever chemotherapy is being used. That's where conceptually one should think about [the use of Enhertu].

Transcript was edited for clarity and conciseness.

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