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Unexpected cardiotoxicity in HER2-mutant non-small cell lung cancer patients treated with trastuzumab deruxtecan

Open AccessPublished:November 09, 2022DOI:https://doi.org/10.1016/j.jtocrr.2022.100432
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      KEYPOINTS

      • ADC targeting HER2 are a promising targeted therapy for HER2-mutant NSCLC
      • First two cases of trastuzumab deruxtecan-induced cardiotoxicity in the form of acute myocarditis in lung cancer patients
      • Routine cardiovascular risk screening and troponin monitoring is advisable, with close collaboration between cardiology specialists and oncologists.

      ABSTRACT

      Antibody-drug conjugates (ADC) targeting receptor tyrosine-protein kinase erbB-2 (ERBB2, HER2) have emerged as promising targeted options for HER2-mutant non-small cell lung cancer (NSCLC). Among ADCs targeting HER2, trastuzumab deruxtecan has shown the most impressive efficacy and is a potential new standard of care. Drug-related interstitial lung disease remains a serious unpredictable identified risk for patients treated with trastuzumab deruxtecan, requiring careful monitoring and multidisciplinary management. We report the first two cases of drug-related cardiotoxicity with acute myocarditis that developed after the first trastuzumab deruxtecan cycle. Routine cardiovascular risk screening is advisable, with close collaboration between cardiology specialists and oncologists.

      KEYWORDS