Effective Management of ADC-Associated Toxicities in TNBC

Toxicity management is a cornerstone of safe and effective antibody–drug conjugate (ADC) therapy in triple-negative breast cancer (TNBC). Clinical practice integrates proactive monitoring and guideline-based interventions to address common adverse events, including neutropenia, interstitial lung disease (ILD), ocular toxicities, and stomatitis. For instance, neutropenia associated with sacituzumab govitecan (SG) is managed with dose adjustments, growth factor support, and routine blood count monitoring, while ILD linked to trastuzumab deruxtecan (T-Dxd) requires early detection, corticosteroid therapy, and treatment interruption as needed. Screening and management of ocular toxicities and stomatitis follow established guidelines, such as those from the American Academy of Ophthalmology. Evidence from the PRIMED study and other real-world analyses underscores the importance of integrating structured AE management strategies into ADC protocols to optimize patient safety, maintain dose intensity, and improve overall treatment outcomes in TNBC.