TY - JOUR
T1 - Safety profile of trastuzumab-emtansine (T-DM1) with concurrent radiation therapy
T2 - A systematic review and meta-analysis
AU - Salvestrini, Viola
AU - Kim, Kyubo
AU - Caini, Saverio
AU - Alkner, Sara
AU - Ekholm, Maria
AU - Skyttä, Tanja
AU - Becherini, Carlotta
AU - Coles, Charlotte E.
AU - Kaidar-Person, Orit
AU - Offersen, Birgitte
AU - de Azambuja, Evandro
AU - Visani, Luca
AU - Cortes, Javier
AU - Harbeck, Nadia
AU - Rugo, Hope S.
AU - Isacke, Clare M.
AU - Marangoni, Elisabetta
AU - Morandi, Andrea
AU - Lambertini, Matteo
AU - Poortmans, Philip
AU - Livi, Lorenzo
AU - Meattini, Icro
N1 - Publisher Copyright:
© 2023 The Author(s)
PY - 2023/9
Y1 - 2023/9
N2 - Background and Purpose: In recent years, the treatment landscape for breast cancer has undergone significant advancements, with the introduction of several new anticancer agents. One such agent is trastuzumab emtansine (T-DM1), an antibody drug conjugate that has shown improved outcomes in both early and advanced breast cancer. However, there is currently a lack of comprehensive evidence regarding the safety profile of combining T-DM1 with radiation therapy (RT). In this study, we aim to provide a summary of the available data on the safety of combining RT with T-DM1 in both early and metastatic breast cancer settings. Materials and Methods: This systematic review and meta-analysis project is part of the consensus recommendations by the European Society for Radiotherapy and Oncology (ESTRO) Guidelines Committee on integrating RT with targeted treatments for breast cancer. A thorough literature search was conducted using the PUBMED/MedLine, Embase, and Cochrane databases to identify original studies focusing on the safety profile of combining T-DM1 with RT. Results: After applying eligibility criteria, nine articles were included in the meta-analysis. Pooled data from these studies revealed a high incidence of grade 3 + radionecrosis (17%), while the rates of grade 3 + radiation-related pneumonitis (<1%) and skin toxicity (1%) were found to be very low. Conclusion: Although there is some concern regarding a slight increase in pneumonitis when combining T-DM1 with postoperative RT, the safety profile of this combination was deemed acceptable for locoregional treatment in non-metastatic breast cancer. However, caution is advised when irradiating intracranial sites concurrently with T-DM1. There is a pressing need for international consensus guidelines regarding the safety considerations of combining T-DM1 and RT for breast cancer.
AB - Background and Purpose: In recent years, the treatment landscape for breast cancer has undergone significant advancements, with the introduction of several new anticancer agents. One such agent is trastuzumab emtansine (T-DM1), an antibody drug conjugate that has shown improved outcomes in both early and advanced breast cancer. However, there is currently a lack of comprehensive evidence regarding the safety profile of combining T-DM1 with radiation therapy (RT). In this study, we aim to provide a summary of the available data on the safety of combining RT with T-DM1 in both early and metastatic breast cancer settings. Materials and Methods: This systematic review and meta-analysis project is part of the consensus recommendations by the European Society for Radiotherapy and Oncology (ESTRO) Guidelines Committee on integrating RT with targeted treatments for breast cancer. A thorough literature search was conducted using the PUBMED/MedLine, Embase, and Cochrane databases to identify original studies focusing on the safety profile of combining T-DM1 with RT. Results: After applying eligibility criteria, nine articles were included in the meta-analysis. Pooled data from these studies revealed a high incidence of grade 3 + radionecrosis (17%), while the rates of grade 3 + radiation-related pneumonitis (<1%) and skin toxicity (1%) were found to be very low. Conclusion: Although there is some concern regarding a slight increase in pneumonitis when combining T-DM1 with postoperative RT, the safety profile of this combination was deemed acceptable for locoregional treatment in non-metastatic breast cancer. However, caution is advised when irradiating intracranial sites concurrently with T-DM1. There is a pressing need for international consensus guidelines regarding the safety considerations of combining T-DM1 and RT for breast cancer.
KW - Breast cancer
KW - Meta-analysis
KW - Radiotherapy
KW - Systematic review
KW - T-DM1
KW - Trastuzumab emtansine
UR - http://www.scopus.com/inward/record.url?scp=85166661686&partnerID=8YFLogxK
U2 - 10.1016/j.radonc.2023.109805
DO - 10.1016/j.radonc.2023.109805
M3 - Review article
C2 - 37437610
AN - SCOPUS:85166661686
SN - 0167-8140
VL - 186
JO - Radiotherapy and Oncology
JF - Radiotherapy and Oncology
M1 - 109805
ER -
