Management of Trastuzumab Deruxtecan-Induced Heart Failure and Pneumonitis in a Patient with HER2-Positive Metastatic Breast Cancer
Trastuzumab Deruxtecan-Induced HF and Pneumonia
DOI:
https://doi.org/10.5281/zenodo.15570010Keywords:
Receptor, ErbB-2, Trastuzumab Deruxtecan, Heart Failure, Pneumonitis, SteroidsAbstract
We report a case of a 49-year-old female with HER2-positive metastatic breast cancer treated with trastuzumab deruxtecan (T-DXd) after progression on multiple prior lines of therapy. Following the third cycle, she developed dyspnea and was admitted to the coronary intensive care unit with heart failure and pulmonary edema. Echocardiography revealed an ejection fraction (EF) of 10-15%. Imaging demonstrated unilateral pleural effusion and bilateral pulmonary infiltrates. Clinical findings were attributed to T-DXd-induced heart failure, bicytopenia, and pneumonitis. The patient responded well to corticosteroid therapy, showing resolution of pulmonary findings and an improved EF (30-35%) over two weeks. This case highlights the importance of monitoring and managing cardiopulmonary adverse events in patients receiving T-DXd.
References
Modi S, Saura C, Yamashita T, et al. Trastuzumab Deruxtecan in Previously Treated HER2-Positive Breast Cancer. N Engl J Med. 2020;382(7):610-621. doi:10.1056/NEJMoa1914510
Rugo HS, Im SA, Cardoso F, et al. Efficacy and safety of trastuzumab deruxtecan versus trastuzumab emtansine in patients with HER2-positive metastatic breast cancer: results from DESTINY-Breast03. J Clin Oncol. 2023;41(2):201-210.
Li BT, Smit EF, Goto Y, et al. Trastuzumab Deruxtecan in HER2-Mutant Non-Small-Cell Lung Cancer. N Engl J Med. 2022;386(3):241-251. doi:10.1056/NEJMoa2112431
Saura C, Modi S, Krop I, et al. Trastuzumab deruxtecan in previously treated patients with HER2-positive metastatic breast cancer: updated survival results from a phase II trial (DESTINY-Breast01). Ann Oncol. 2024;35(3):302-307. doi:10.1016/j.annonc.2023.12.001
Tolaney SM, Wardley AM, Zambelli S, et al. Monitoring strategies for trastuzumab deruxtecan-associated toxicities. J Clin Oncol. 2020;38(3):197-204.
Cardinale D, Colombo A, Lamantia G, et al. Anthracycline-induced cardiomyopathy: clinical relevance and response to pharmacologic therapy. J Am Coll Cardiol. 2010;55(3):213-220. doi:10.1016/j.jacc.2009.03.095
Emens LA, Middleton G. The interplay of immunotherapy and chemotherapy: harnessing potential synergies. Cancer Immunol Res. 2015;3(5):436-443. doi:10.1158/2326-6066.CIR-15-0064
Downloads
Published
How to Cite
License
Copyright (c) 2025 Mustafa Seyyar, Pervin Can Şancı, Devrim Çabuk
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND 4.0)
