Managing Enhertu and Perjeta Side Effects in Breast Cancer Treatment

Antibody-drug conjugates (ADCs) are rapidly changing the treatment landscape for patients with breast cancer, offering a more targeted approach by delivering potent chemotherapy directly to cancer cells. However, while these treatments can be highly effective, they also bring a unique set of side effects that require careful management to maintain quality of life.

During the 43rd annual Miami Breast Cancer Conference, Dr. Kevin Kalinsky, director of the Glenn Family Breast Center at Winship Cancer Institute of Emory University, sat down with CURE to discuss the rise of these therapies. During the conference, Kalinsky participated in the CURE Educated Patient Breast Cancer Summit, where he shared insights with patients and caregivers on navigating the evolving ADC landscape.

Kalinsky broke down the common toxicities associated with current ADCs and explains how the care team works to prevent and mitigate these issues.

Transcript

"We’ve recently seen the FDA approval of Enhertu (trastuzumab deruxtecan, T-DXd) plus Perjeta (pertuzumab) for HER2-positive disease. While combining these powerful tools increases efficacy, patients often worry about compounding side effects. Based on your research, how are we getting better at managing the unique toxicity profiles—like interstitial lung disease (ILD) or stomatitis—when we stack these therapies together?"

I mean, specifically with [Enhertu] and [Perjeta], the things that we look for include nausea and vomiting, fatigue, see some diarrhea with the [Perjeta] and maybe some skin rashes. I still think the main issue that we see with this particular combination is the risk for pulmonary disease, for lung disease, and we see that in about 10% of patients, that they can have some grade 2 (moderate) or higher disease. And what that means is it's really important to closely monitor with scans to make sure that that's not developing. And if it is, to think about giving steroids and you have a pause to the [Enhertu], and then also knowing that if really somebody becomes symptomatic and they're having a cough or shortness of breath, we have to stop the [Enhertu]. So that's why monitoring is so critical.

Transcript has been edited for clarity and conciseness.

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