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Safety profile of trastuzumab-emtansine (T-DM1) with concurrent radiation therapy : A systematic review and meta-analysis

Salvestrini, Viola (author)
Careggi University Hospital,University of Florence,Univ Florence, Italy; Azienda Osped Univ Careggi, Italy
Kim, Kyubo (author)
Ewha Womans University,University of Florence,Univ Florence, Italy; Ewha Womans Univ, South Korea
Caini, Saverio (author)
Institute for Cancer Research, Prevention and Clinical Network (ISPRO),Inst Canc Res Prevent & Clin Network ISPRO, Italy
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Alkner, Sara (author)
Lund University,Lunds universitet,LUCC: Lunds universitets cancercentrum,Övriga starka forskningsmiljöer,Bröstcancerbehandling,Sektion I,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,LUCC: Lund University Cancer Centre,Other Strong Research Environments,Breast cancer treatment,Section I,Department of Clinical Sciences, Lund,Faculty of Medicine,Skåne University Hospital,Skane Univ Hosp, Sweden; Lund Univ, Sweden
Ekholm, Maria (author)
Linköpings universitet,Linköping University,Region Jönköping County,Avdelningen för kirurgi, ortopedi och onkologi,Medicinska fakulteten,Dept Oncol, Sweden
Skyttä, Tanja (author)
Tampere University Hospital,Tampere Univ Hosp, Finland
Becherini, Carlotta (author)
Careggi University Hospital,University of Florence,Univ Florence, Italy; Azienda Osped Univ Careggi, Italy
Coles, Charlotte E. (author)
University of Cambridge,Univ Cambridge, England
Kaidar-Person, Orit (author)
Tel-Aviv University,Sheba Medical Center,Maastricht University,Sheba Med Ctr, Israel; Tel Aviv Univ, Israel; Maastricht Univ, Netherlands
Offersen, Birgitte (author)
Aarhus University Hospital,Aarhus Univ Hosp, Denmark
de Azambuja, Evandro (author)
Université Libre de Bruxelles (ULB),Univ Libre Bruxelles ULB, Belgium
Visani, Luca (author)
Careggi University Hospital,University of Florence,Univ Florence, Italy
Cortes, Javier (author)
Pangaea Oncology,European University of Madrid,Int Breast Canc Ctr IBCC, Spain; Univ Europea Madrid, Spain
Harbeck, Nadia (author)
University Hospital Munich,LMU Univ Hosp, Germany
Rugo, Hope S. (author)
UCSF Helen Diller Family Comprehensive Cancer Center,UCSF Helen Diller Family Comprehens Canc Ctr, CA USA
Isacke, Clare M. (author)
Institute of Cancer Research London,Breast Canc Now Res Ctr, England
Marangoni, Elisabetta (author)
Curie Institute, Paris,Inst Curie, France
Morandi, Andrea (author)
University of Florence,Univ Florence, Italy
Lambertini, Matteo (author)
University of Genoa,Ospedale Policlinico San Martino,Univ Genoa, Italy; IRCCS Osped Policlin San Martino, Italy
Poortmans, Philip (author)
Iridium Netwerk, Belgium; Univ Antwerp, Belgium,University of Antwerp
Livi, Lorenzo (author)
University of Florence,Careggi University Hospital,Univ Florence, Italy; Azienda Osped Univ Careggi, Italy
Meattini, Icro (author)
Careggi University Hospital,University of Florence,Univ Florence, Italy; Azienda Osped Univ Careggi, Italy; Univ Florence, Italy
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 (creator_code:org_t)
ELSEVIER IRELAND LTD, 2023
2023
English.
In: Radiotherapy and Oncology. - : ELSEVIER IRELAND LTD. - 0167-8140 .- 1879-0887. ; 186
Related links:
http://dx.doi.org/10... (free)
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https://liu.diva-por... (primary) (Raw object)
https://lup.lub.lu.s...
https://doi.org/10.1...
https://urn.kb.se/re...
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  • Research review (peer-reviewed)
Abstract Subject headings
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  • 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.

Subject headings

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Cancer och onkologi (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Cancer and Oncology (hsv//eng)

Keyword

Breast cancer
Meta-analysis
Radiotherapy
Systematic review
T-DM1
Trastuzumab emtansine
Breast cancer; Meta-analysis; Systematic review; Radiotherapy; T-DM1; Trastuzumab emtansine

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