Clinical best practices in optimal monitoring, early diagnosis, and effective management of antibody–drug conjugate-induced interstitial lung disease or pneumonitis: a multidisciplinary team approach in Singapore

ABSTRACT Introduction Interstitial lung disease (ILD) or pneumonitis remains an important adverse event identified with treatment with antibody–drug conjugates (ADCs). Drug-induced ILD (DILD) accounts for 3%–5% of common ILD cases and is a significant problem in clinical practice. Hence, with the anticipation of the widespread use of ADCs, it will be important for guidelines and recommendations to be established to direct and standardize the management of DILD by a multidisciplinary team (MDT). Areas covered A thorough literature search was conducted using PubMed to identify relevant articles related to ADCs published between 1 January 2010 and 31 November 2022. Based on the review of the literature combined with expert opinions, this review article offers an overview of incidences of ILDs associated with the use of newer anticancer therapies, specifically ADCs, and discusses local-regional best practices in optimal monitoring, early diagnosis, and management of DILD involving an MDT. Expert opinion Multidisciplinary input and consensus are crucial in the accurate diagnosis of DILD. The core group of essential attendees in the MDT are oncologists, pulmonologists, thoracic radiologists, and pathologists. This allows for the integration of expertise from different specialists to achieve a ‘best fit’ diagnosis and management.

[1]  Hong Zhu,et al.  Treatment‐related adverse events of antibody–drug conjugates in clinical trials: A systematic review and meta‐analysis , 2022, Cancer.

[2]  F. Montemurro,et al.  Final results of the global and Asia cohorts of KAMILLA, a phase IIIB safety trial of trastuzumab emtansine in patients with HER2-positive advanced breast cancer , 2022, ESMO open.

[3]  P. Jänne,et al.  LBA55 Trastuzumab deruxtecan (T-DXd) in patients (Pts) with HER2-mutant metastatic non-small cell lung cancer (NSCLC): Interim results from the phase 2 DESTINY-Lung02 trial , 2022, Annals of Oncology.

[4]  Sung-Bae Kim,et al.  Trastuzumab Deruxtecan in Previously Treated HER2-Low Advanced Breast Cancer , 2022, New England Journal of Medicine.

[5]  Min Hwan Kim,et al.  Trastuzumab Deruxtecan versus Trastuzumab Emtansine for Breast Cancer. , 2022, The New England journal of medicine.

[6]  A. Nicholson,et al.  Multidisciplinary clinical guidance on trastuzumab deruxtecan (T-DXd)-related interstitial lung disease/pneumonitis-Focus on proactive monitoring, diagnosis, and management. , 2022, Cancer treatment reviews.

[7]  P. Ascierto,et al.  Drug-induced interstitial lung disease during cancer therapies: expert opinion on diagnosis and treatment , 2022, ESMO open.

[8]  M. Brimble,et al.  An Insight into FDA Approved Antibody-Drug Conjugates for Cancer Therapy , 2021, Molecules.

[9]  P. Jänne,et al.  Trastuzumab Deruxtecan in HER2-Mutant Non-Small-Cell Lung Cancer. , 2021, The New England journal of medicine.

[10]  K. Tamura,et al.  279P Trastuzumab deruxtecan (T-DXd) in patients with HER2-positive metastatic breast cancer (MBC): Updated survival results from a phase II trial (DESTINY-Breast01) , 2021, Annals of Oncology.

[11]  J. Ajani,et al.  LBA55 Primary analysis of a phase II single-arm trial of trastuzumab deruxtecan (T-DXd) in western patients (Pts) with HER2-positive (HER2+) unresectable or metastatic gastric or gastroesophageal junction (GEJ) cancer who progressed on or after a trastuzumab-containing regimen , 2021, Annals of Oncology.

[12]  Lingyu Li,et al.  The promising role of antibody drug conjugate in cancer therapy: Combining targeting ability with cytotoxicity effectively , 2021, Cancer medicine.

[13]  Y. Bang,et al.  Trastuzumab deruxtecan (T-DXd; DS-8201) in patients with HER2-positive advanced gastric or gastroesophageal junction (GEJ) adenocarcinoma: Final overall survival (OS) results from a randomized, multicenter, open-label, phase 2 study (DESTINY-Gastric01). , 2021 .

[14]  B. Monk,et al.  Efficacy and safety of tisotumab vedotin in previously treated recurrent or metastatic cervical cancer (innovaTV 204/GOG-3023/ENGOT-cx6): a multicentre, open-label, single-arm, phase 2 study. , 2021, The Lancet. Oncology.

[15]  T. Prochilo,et al.  Drug-Related Pneumonitis in Cancer Treatment during the COVID-19 Era , 2021, Cancers.

[16]  T. Powles,et al.  Enfortumab Vedotin in Previously Treated Advanced Urothelial Carcinoma. , 2021, The New England journal of medicine.

[17]  C. Criscitiello,et al.  Antibody–drug conjugates in solid tumors: a look into novel targets , 2021, Journal of Hematology & Oncology.

[18]  D. Lynch,et al.  Chest CT Diagnosis and Clinical Management of Drug-related Pneumonitis in Patients Receiving Molecular Targeting Agents and Immune Checkpoint Inhibitors: A Position Paper from the Fleischner Society. , 2021, Chest.

[19]  A. Bardia,et al.  Sacituzumab Govitecan in Previously Treated Hormone Receptor-Positive/HER2-Negative Metastatic Breast Cancer: Final Results from a Phase 1/2, Single-Arm, Basket Trial. , 2020, Annals of oncology : official journal of the European Society for Medical Oncology.

[20]  M. Dimopoulos,et al.  Trastuzumab Deruxtecan (DS-8201a): The Latest Research and Advances in Breast Cancer. , 2020, Clinical breast cancer.

[21]  Mona G. Flores,et al.  Artificial intelligence for the detection of COVID-19 pneumonia on chest CT using multinational datasets , 2020, Nature Communications.

[22]  Jonathan H. Chung,et al.  Diagnosis of Hypersensitivity Pneumonitis in Adults. An Official ATS/JRS/ALAT Clinical Practice Guideline , 2020, American journal of respiratory and critical care medicine.

[23]  H. Iwata,et al.  Incidence of pneumonitis/interstitial lung disease induced by HER2-targeting therapy for HER2-positive metastatic breast cancer , 2020, Breast Cancer Research and Treatment.

[24]  Y. Bang,et al.  Trastuzumab Deruxtecan in Previously Treated HER2-Positive Gastric Cancer. , 2020, The New England journal of medicine.

[25]  L. Bashoura,et al.  What's the Price? Toxicities of Targeted Therapies in Breast Cancer Care. , 2020, American Society of Clinical Oncology educational book. American Society of Clinical Oncology. Annual Meeting.

[26]  David C. Smith,et al.  EV-101: A Phase I Study of Single-Agent Enfortumab Vedotin in Patients With Nectin-4–Positive Solid Tumors, Including Metastatic Urothelial Carcinoma , 2020, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[27]  K. Chuah,et al.  Impact of an interstitial lung disease service in the diagnosis and management of interstitial lung disease in Singapore. , 2020, Singapore medical journal.

[28]  FDA approves fam-trastuzumab deruxtecan-nxki for unresectable or metastatic HER2-positive breast cancer , 2019, Case Medical Research.

[29]  Sung-Bae Kim,et al.  Trastuzumab Deruxtecan in Previously Treated HER2-Positive Breast Cancer. , 2019, The New England journal of medicine.

[30]  S. Röhrich,et al.  [Artificial intelligence in lung imaging]. , 2019, Der Radiologe.

[31]  H. Prosch,et al.  Künstliche Intelligenz in der Bildgebung der Lunge , 2019, Der Radiologe.

[32]  M. Govoni,et al.  The Role of the Multidisciplinary Evaluation of Interstitial Lung Diseases: Systematic Literature Review of the Current Evidence and Future Perspectives , 2019, Front. Med..

[33]  M. Galsky,et al.  Pivotal Trial of Enfortumab Vedotin in Urothelial Carcinoma After Platinum and Anti-Programmed Death 1/Programmed Death Ligand 1 Therapy , 2019, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[34]  C. Redfern,et al.  Trastuzumab deruxtecan (DS-8201a) in patients with advanced HER2-positive breast cancer previously treated with trastuzumab emtansine: a dose-expansion, phase 1 study. , 2019, The Lancet. Oncology.

[35]  FDA approves ado-trastuzumab emtansine for early breast cancer , 2019, Case Medical Research.

[36]  T. Agatsuma,et al.  The Latest Research and Development into the Antibody-Drug Conjugate, [fam-] Trastuzumab Deruxtecan (DS-8201a), for HER2 Cancer Therapy. , 2019, Chemical & pharmaceutical bulletin.

[37]  R. Plummer,et al.  Tisotumab vedotin in patients with advanced or metastatic solid tumours (InnovaTV 201): a first-in-human, multicentre, phase 1-2 trial. , 2019, The Lancet. Oncology.

[38]  P. Ellis,et al.  Safety of trastuzumab emtansine (T-DM1) in patients with HER2-positive advanced breast cancer: Primary results from the KAMILLA study cohort 1. , 2019, European journal of cancer.

[39]  Robert Stirrups Sacituzumab govitecan-hziy for triple-negative breast cancer. , 2019, The Lancet. Oncology.

[40]  A. Bardia,et al.  Sacituzumab Govitecan‐hziy in Refractory Metastatic Triple‐Negative Breast Cancer , 2019, The New England journal of medicine.

[41]  M. Molina-Molina,et al.  Interstitial Lung Diseases in Developing Countries , 2019, Annals of global health.

[42]  I. Bruce,et al.  Drug-Induced Interstitial Lung Disease: A Systematic Review , 2018, Journal of clinical medicine.

[43]  M. Suarez‐Almazor,et al.  Management of Immune-Related Adverse Events in Patients Treated With Immune Checkpoint Inhibitor Therapy: American Society of Clinical Oncology Clinical Practice Guideline. , 2018, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[44]  A. Sheshadri,et al.  Immune-Related Adverse Events: Pneumonitis. , 2018, Advances in experimental medicine and biology.

[45]  Sarah Talamantes,et al.  Interstitial Pneumonitis Secondary to Trastuzumab: A Case Report and Literature Review , 2017, Case Reports in Oncology.

[46]  E. Evron,et al.  Paclitaxel-induced pneumonitis in patients with breast cancer: case series and review of the literature , 2017, Journal of chemotherapy.

[47]  Carlos Barrios,et al.  Atezolizumab versus docetaxel in patients with previously treated non-small-cell lung cancer (OAK): a phase 3, open-label, multicentre randomised controlled trial , 2017, The Lancet.

[48]  W. Cooper,et al.  Clinical impact of the interstitial lung disease multidisciplinary service , 2016, Respirology.

[49]  Y. Shentu,et al.  Pembrolizumab versus Chemotherapy for PD-L1-Positive Non-Small-Cell Lung Cancer. , 2016, The New England journal of medicine.

[50]  F. Hodi,et al.  PD-1 Inhibitor–Related Pneumonitis in Advanced Cancer Patients: Radiographic Patterns and Clinical Course , 2016, Clinical Cancer Research.

[51]  R. Bourgon,et al.  Atezolizumab in patients with locally advanced and metastatic urothelial carcinoma who have progressed following treatment with platinum-based chemotherapy: a single-arm, multicentre, phase 2 trial , 2016, The Lancet.

[52]  L. Spencer,et al.  A Review of the Multidisciplinary Diagnosis of Interstitial Lung Diseases: A Retrospective Analysis in a Single UK Specialist Centre , 2016, Journal of clinical medicine.

[53]  Andreas Günther,et al.  Exploring Clinical and Epidemiological Characteristics of Interstitial Lung Diseases: Rationale, Aims, and Design of a Nationwide Prospective Registry—The EXCITING-ILD Registry , 2015, BioMed research international.

[54]  S. Oudard,et al.  Bleomycin-Induced Pneumonitis in the Treatment of Ovarian Sex Cord–Stromal Tumors: A Systematic Review and Meta-analysis , 2015, International Journal of Gynecologic Cancer.

[55]  Yang Yao,et al.  Risk of interstitial lung disease associated with EGFR-TKIs in advanced non-small-cell lung cancer: a meta-analysis of 24 phase III clinical trials , 2015, Journal of chemotherapy.

[56]  T. Miki,et al.  Differences in adverse event profiles between everolimus and temsirolimus and the risk factors for non-infectious pneumonitis in advanced renal cell carcinoma , 2015, International Journal of Clinical Oncology.

[57]  N. Harbeck,et al.  Trastuzumab emtansine in human epidermal growth factor receptor 2-positive metastatic breast cancer: an integrated safety analysis. , 2014, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[58]  Sung-Bae Kim,et al.  Trastuzumab emtansine versus treatment of physician's choice for pretreated HER2-positive advanced breast cancer (TH3RESA): a randomised, open-label, phase 3 trial. , 2014, The Lancet. Oncology.

[59]  K. Meyer,et al.  Diagnosis and management of interstitial lung disease , 2014, Translational Respiratory Medicine.

[60]  M. Kusumoto,et al.  Consensus statement for the diagnosis and treatment of drug-induced lung injuries. , 2013, Respiratory investigation.

[61]  Charlie Strange,et al.  An official American Thoracic Society clinical practice guideline: the clinical utility of bronchoalveolar lavage cellular analysis in interstitial lung disease. , 2012, American journal of respiratory and critical care medicine.

[62]  J. Baselga,et al.  Trastuzumab emtansine for HER2-positive advanced breast cancer. , 2012, The New England journal of medicine.

[63]  M. Schwaiblmair,et al.  Drug Induced Interstitial Lung Disease , 2012, The open respiratory medicine journal.

[64]  A. Gemma,et al.  Clarification of clinical features of interstitial lung disease induced by irinotecan based on postmarketing surveillance data and spontaneous reports , 2011, Anti-cancer drugs.

[65]  Norbert Hollaender,et al.  Phase 3 trial of everolimus for metastatic renal cell carcinoma , 2010, Cancer.

[66]  T. Doherty,et al.  Association of cetuximab with adverse pulmonary events in cancer patients: a comprehensive review , 2009, Journal of experimental & clinical cancer research : CR.

[67]  A. Rhodes,et al.  Oxford Desk Reference: Critical Care , 2008 .

[68]  A. Wells,et al.  Interstitial lung disease guideline , 2008, Thorax.

[69]  P. Marik,et al.  Pulmonary complications of novel antineoplastic agents for solid tumors. , 2008, Chest.

[70]  M. Dowsett,et al.  Trastuzumab after adjuvant chemotherapy in HER2-positive breast cancer. , 2005, The New England journal of medicine.

[71]  Paul J. Friedman,et al.  American Thoracic Society/European Respiratory Society International Multidisciplinary Consensus Classification of the Idiopathic Interstitial Pneumonias. This joint statement of the American Thoracic Society (ATS), and the European Respiratory Society (ERS) was adopted by the ATS board of directors , 2002, American journal of respiratory and critical care medicine.

[72]  R. Balbontín,et al.  [Interstitial lung diseases]. , 1985, Revista medica de Chile.