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01-08-2020 | Breast Cancer | Review

Incidence of pneumonitis/interstitial lung disease induced by HER2-targeting therapy for HER2-positive metastatic breast cancer

Authors: Michelle D. Hackshaw, Heather E. Danysh, Jasmeet Singh, Mary E. Ritchey, Amy Ladner, Corina Taitt, D. Ross Camidge, Hiroji Iwata, Charles A. Powell

Published in: Breast Cancer Research and Treatment | Issue 1/2020

Abstract

Purpose

Anti-human epidermal growth factor receptor 2 (HER2) therapies are associated with interstitial lung disease (ILD), also referred to as pneumonitis. In this literature review, we describe the incidence of ILD among patients with HER2-positive metastatic breast cancer (MBC) receiving anti-HER2 therapies, and we describe existing recommendations for monitoring and managing drug-induced ILD among these patients.

Methods

We searched PubMed and Embase to identify clinical trials and postmarket observational studies that investigated anti-HER2 therapies for HER2-positive MBC, reported on ILD, and were published during January 1, 2009 to July 15, 2019. Articles were screened by two researchers; data were extracted from the full-text articles.

Results

The 18 articles selected for this review assessed 9,886 patients who received trastuzumab (8 articles), lapatinib (4 articles), trastuzumab emtansine (3 articles), trastuzumab deruxtecan (2 articles), or trastuzumab duocarmazine (1 article). The overall incidence of all-grade ILD was 2.4% (n = 234), with 66.7% (n = 156) occurring as grade 1–2 events, 0.5% grade 3–4 (n = 54; incidence), and 0.2% grade 5 (n = 16; incidence). The highest ILD incidence (21.4%) was among patients receiving trastuzumab combined with everolimus and paclitaxel. Ten studies indicated that ILD events were managed via dose interruption, dose reduction, or treatment discontinuation; two studies included detailed guidelines on managing drug-induced ILD.

Conclusions

ILD is a well-described adverse drug reaction associated with several anti-HER2 drugs. Published ILD management guidelines are available for few anti-HER2 treatment regimens; however, guidance for monitoring for anti-HER2 drug-induced ILD is lacking.

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Title: Incidence of pneumonitis/interstitial lung disease induced by HER2-targeting therapy for HER2-positive metastatic breast cancer
Authors: Michelle D. Hackshaw
Heather E. Danysh
Jasmeet Singh
Mary E. Ritchey
Amy Ladner
Corina Taitt
D. Ross Camidge
Hiroji Iwata
Charles A. Powell
Publication date: 01-08-2020
Publisher: Springer US
Keywords: Breast Cancer
Breast Cancer
Lapatinib
Trastuzumab
Trastuzumab Deruxtecan
Trastuzumab Emtansine
Everolimus
Published in: Breast Cancer Research and Treatment / Issue 1/2020
Print ISSN: 0167-6806
Electronic ISSN: 1573-7217
DOI: https://doi.org/10.1007/s10549-020-05754-8

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