Multidisciplinary clinical guidance on trastuzumab deruxtecan (T-DXd)-related interstitial lung disease/pneumonitis-Focus on proactive monitoring, diagnosis, and management.

TL;DR: It is suggested that patients with DAD patterns have poor outcomes in T-DXd-related ILD/pneumonitis cases in clinical practice, and a larger real-world dataset may further identify predictors of clinical outcome.

TL;DR: This review will explore current issues with HER2 testing, recently approved drugs in the HER2+ and HER2 low spaces, as well as novel agents/combinations on the horizon.

TL;DR: Trastuzumab deruxtecan (T-DXd) is a HER2-targeted ADC showing significant efficacy in HER2-mutant metastatic NSCLC, with manageable safety profile, but notable interstitial lung disease risk, and improved tolerability at 5.4 mg/kg dose.

Abstract: Introduction Sacituzumab govitecan (SG) as an antibody-drug conjugate targeting Trophoblast cell surface antigen 2, has emerged as a promising therapy for breast cancer. However, the efficacy of SG across disease subtypes, treatment settings, and in combination regimens remains incompletely defined. Materials and methods A comprehensive literature search was conducted in PubMed, Embase, Web of Science, and the Cochrane Library to identify studies reporting the clinical efficacy and safety outcomes of SG in breast cancer. Pooled analyses were performed for overall response rate (ORR), progression-free survival (PFS), overall survival (OS), and treatment-related adverse events (AEs). Subgroup analyses were performed by molecular subtype, disease stage, and treatment regimen. Results A total of 13 studies involving 2,447 patients with breast cancer were included. SG significantly improved ORR (OR = 3.97, 95%CIs: 1.32-11.90) and OS (HR = 0.59, 95%CIs: 0.47-0.75) versus single agent chemotherapy in RCTs, with pronounced benefit in metastatic triple-negative breast cancer (mTNBC) (ORR = 10.55; HR for OS: 0.50, 95%CIs: 0.43-0.58). Pooled median PFS (mPFS) was 4.95 months (95%CIs: 4.36-5.61months) in RCTs and 5.93 months (95%CIs: 4.76-7.39 months) in single-arm studies, with early-stage TNBC achieving mPFS up to 9.50 months (95%CIs: 8.91-10.13 months). Combination with immunotherapy suggested numerically longer survival (median OS 18.0 vs 12.2 months). The most frequent grade ≥3 AE was neutropenia, occurring in 26-57% of patients, with overall toxicity manageable and consistent across studies. Conclusions SG provides substantial clinical benefit in breast cancer, improving ORR, OS, and PFS, particularly in TNBC, with consistent efficacy across monotherapy and combination regimens. The increased risk of hematologic and gastrointestinal toxicities warrants careful monitoring in clinical practice. Systematic review registration https://www.crd.york.ac.uk/PROSPERO/ , identifier CRD420251072321.

TL;DR: The guideline panel provided recommendations related to the diagnosis of IPF, including a conditional recommendation for multidisciplinary discussion and a strong recommendation against measurement of serum biomarkers for the sole purpose of distinguishing IPF from other ILDs.

TL;DR: Recommendations for specific organ system-based toxicity diagnosis and management are presented and, in general, permanent discontinuation of ICPis is recommended with grade 4 toxicities, with the exception of endocrinopathies that have been controlled by hormone replacement.

TL;DR: Calcium, CRP, C-reactive protein, CT, computed tomography, ESR, sedimentation rate, and checkpoint are used to estimate the concentration of phosphorous in the sediments.

TL;DR: A multidisciplinary Toxicity Management Working Group met for a full-day workshop to develop recommendations to standardize management of immune-related adverse events, and presents their consensus recommendations on managing toxicities associated with immune checkpoint inhibitor therapy.