Dr. Rimawi on Mitigating Interstitial Lung Disease in HER2+ Breast Cancer

Mothaffar Fahed Rimawi, MD, professor, Department of Medicine, Section of Hematology and Oncology, executive medical director, associate director of clinical affairs, co-leader, Breast Cancer Program, chief of oncology service line, Dan L. Duncan Comprehensive Cancer Center, Baylor College of Medicine, discusses mitigating interstitial lung disease (ILD)/pneumonitis in HER2-positive breast cancer.

ILD remains an adverse effect of special interest associated with fam-trastuzumab deruxtecan-nxki (Enhertu) in HER2-positive breast cancer, Rimawi says. Moreover, the toxicity requires vigilant monitoring for early identification, mitigation, and management.

As the uptake of trastuzumab deruxtecan grows in HER2-positive breast cancer, the field is moving toward increased screening for ILD and implementation of proactive management strategies, Rimawi says. Additional safety data from the phase 3 DESTINY-Breast03 trial (NCT03529110), as well as the results of the ongoing phase 3 DESTINY-Breast09 trial (NCT04784715), will continue to underscore the importance of monitoring for ILD in this patient population.

Currently, risk factors for ILD are unknown but could include underlying pulmonary disease and smoking history. However, increased monitoring strategies, including ordering baseline pulmonary function tests and taking comprehensive patient histories to identify potential risk factors, are needed to further understand this toxicity, Rimawi concludes.