TY - JOUR
T1 - Safety profile of trastuzumab-emtansine (T-DM1) with concurrent radiation therapy
T2 - A systematic review and meta-analysis
AU - Salvestrini, Viola
AU - Kim, Kyubo
AU - Caini, Saverio
AU - Alkner, Sara
AU - Ekholm, Maria
AU - Skyttä, Tanja
AU - Becherini, Carlotta
AU - Coles, Charlotte E.
AU - Kaidar-Person, Orit
AU - Offersen, Birgitte
AU - de Azambuja, Evandro
AU - Visani, Luca
AU - Cortes, Javier
AU - Harbeck, Nadia
AU - Rugo, Hope S.
AU - Isacke, Clare M.
AU - Marangoni, Elisabetta
AU - Morandi, Andrea
AU - Lambertini, Matteo
AU - Poortmans, Philip
AU - Livi, Lorenzo
AU - Meattini, Icro
N1 - Funding Information:
The authors would like to express their gratitude to Tessa Piazzini and Alida Daniele from the Biblioteca Biomedica at the University of Florence, Florence, Italy, for their valuable contribution to the literature search conducted for this study. The research data are securely stored and can be made available upon request to the corresponding author. Charlotte E. Coles (CEC) acknowledges funding from the National Institute of Health and Social Care Research (NIHR) and support from the NIHR Cambridge Biomedical Research Centre. It is important to note that the views expressed in this study are those of the author and do not necessarily represent the views of the NIHR or the Department of Health and Social Care. We extend our thanks to Fondazione Radioterapia Oncologica (FRO) non-profit organization and all those who have provided essential support for scientific research. We also acknowledge the unconditional support of all the companies involved in the implementation of scientific research and studies, including Fondazione Fiorenzo Fratini Onlus, Conad Società Cooperativa, Fabiani Gioiellerie, Permira, Rinascente, Giorgio Tesi Group.
Funding Information:
The authors would like to express their gratitude to Tessa Piazzini and Alida Daniele from the Biblioteca Biomedica at the University of Florence, Florence, Italy, for their valuable contribution to the literature search conducted for this study. The research data are securely stored and can be made available upon request to the corresponding author. Charlotte E. Coles (CEC) acknowledges funding from the National Institute of Health and Social Care Research (NIHR) and support from the NIHR Cambridge Biomedical Research Centre. It is important to note that the views expressed in this study are those of the author and do not necessarily represent the views of the NIHR or the Department of Health and Social Care. We extend our thanks to Fondazione Radioterapia Oncologica (FRO) non-profit organization and all those who have provided essential support for scientific research. We also acknowledge the unconditional support of all the companies involved in the implementation of scientific research and studies, including Fondazione Fiorenzo Fratini Onlus, Conad Società Cooperativa, Fabiani Gioiellerie, Permira, Rinascente, Giorgio Tesi Group.
Publisher Copyright:
© 2023 The Author(s)
PY - 2023/9/1
Y1 - 2023/9/1
N2 - 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.
AB - 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.
KW - Breast cancer
KW - Meta-analysis
KW - Radiotherapy
KW - Systematic review
KW - T-DM1
KW - Trastuzumab emtansine
U2 - 10.1016/j.radonc.2023.109805
DO - 10.1016/j.radonc.2023.109805
M3 - (Systematic) Review article
C2 - 37437610
SN - 0167-8140
VL - 186
JO - Radiotherapy and Oncology
JF - Radiotherapy and Oncology
IS - 1
M1 - 109805
ER -