Strategies to Manage Antibody Drug Conjugates (ADC) - Related Toxicities in Breast Cancer

Medical experts review the currently available antibody-drug conjugates for breast cancer, including Sacituzumab govitecan (Trop-2 directed ADC), Kadcyla (ado-trastuzumab emtansine, T-DM1, HER2-directed ADC), and Enhertu (fam-trastuzumab deruxtecan-nxki, T-DXd, HER2-directed ADC).

Medical experts discuss the distinct mechanisms and components of different antibody-drug conjugates (ADCs), including the drug, antibody, and linker, and how these components contribute to the mechanisms of ADC-related toxicities.

This discussion explores the occurrence and risk factors of neutropenia associated with SG treatment, comparing clinical practice experiences with trial data.

This discussion focuses on strategies to manage neutropenia associated with SG, including the use of prophylactic growth factors and timing of their administration, comparing management approaches between clinicians.

Panelists discuss how to manage sacituzumab govitecan therapy, including absolute neutrophil count cutoffs for dose adjustments, handling febrile neutropenia, comparing diarrhea rates to clinical trials, identifying risk factors, and strategies for managing SG-related diarrhea.

Panelists discuss how to manage side effects of sacituzumab govitecan (SG), including counseling on alopecia, proactive management strategies, routine antiemetic premedications, and adjustments for chemotherapy-induced nausea and vomiting, as well as recommended breakthrough antinausea medications for home use.

Experts on breast cancer discuss the potential adverse events related to trastuzumab deruxtecan (T-DXd).

Experts on breast cancer provide clinical insights on the management of pneumonitis associated with trastuzumab deruxtecan.

Panelists discuss how management and monitoring for pneumonitis and cardiotoxicity in trastuzumab deruxtecan (T-DXd) is similar to trastuzumab emtansine (T-DM1), while also emphasizing the need for awareness of adverse effects such as peripheral neuropathy, thrombocytopenia, and hepatotoxicity, along with strategies for their management and when to consider therapy modifications.

Panelists discuss how the multidisciplinary team plays a crucial role in managing treatment-resistant adverse effects for patients receiving antibody-drug conjugates, emphasizing collaboration among oncologists, pharmacists, nurses, and specialists to optimize patient care and ensure comprehensive support.