Clinical best practices in interdisciplinary management of human epidermal growth factor receptor 2 antibody‐drug conjugates–induced interstitial lung disease/pneumonitis: An expert consensus in China

Author:

Xu Chunwei123,Chen Zhanhong4,Xia Yuanli5,Shi Yanxia6,Fu Peifen7,Chen Yiding8ORCID,Wang Xian9,Zhang Lili10,Li Hengyu11,Chen Wenyan12,Fu Jianfei13,Huang Liming14,Shu Jingde15,Wang Ouchen16,Wu Weizhu17,Xie Bojian18,Wang Ting19,Zhang Weiping20,Shen Shurong21,Li Qun22,Luo Ting23,Zhang Bin24,Xie Yanru25,Wang Hongxia26,Wang Qian27,Wang Wenxian1ORCID,Li Ziming28,Song Zhengbo1,Fang Wenfeng6,Zhong Wenzhao29ORCID,Zhang Yongchang30,Zhan Ping3,Liu Hongbing3ORCID,Lv Tangfeng3,Miao Liyun31ORCID,Min Lingfeng32,Wang Feng33,Meng Rui34,Zhu Youcai35,Wang Lin36,Wan Bing37,Wang Dong3,Hao Yue1,Zhou Jianya5ORCID,Huang Long38,Zhang Zhang39,Lv Donglai40,Fang Meiyu1,Lu Yuanzhi41,Si Lu42,Song Yong3,Wang Xiaojia419

Affiliation:

1. Department of Chemotherapy Chinese Academy of Sciences University Cancer Hospital (Zhejiang Cancer Hospital) Hangzhou Zhejiang China

2. Institute of Cancer and Basic Medicine Chinese Academy of Sciences Hangzhou Zhejiang China

3. Department of Respiratory Medicine Affiliated Jinling Hospital Medical School of Nanjing University Nanjing Jiangsu China

4. Department of Breast Cancer Internal Medicine Zhejiang Cancer Hospital Hangzhou Institute of Medicine Chinese Academy of Sciences Hangzhou Zhejiang China

5. Department of Respiratory Disease Thoracic Disease Center The First Affiliated Hospital School of Medicine Zhejiang University Hangzhou Zhejiang China

6. State Key Laboratory of Oncology in South China Department of Medical Oncology Sun Yat‐sen University Cancer Center Collaborative Innovation Center for Cancer Medicine Guangzhou Guangdong China

7. Department of Breast Surgery The First Affiliated Hospital School of Medicine Zhejiang University Hangzhou Zhejiang China

8. Key Laboratory of Cancer Prevention and Intervention Department of Breast Surgery and Oncology Cancer Institute China National Ministry of Education Second Affiliated Hospital of Zhejiang University School of Medicine Cancer Center Zhejiang University Hangzhou Zhejiang China

9. Department of Medical Oncology Sir Run Run Shaw Hospital Zhejiang University Hangzhou Zhejiang China

10. Department of Oncology Jiangsu Province Hospital and Nanjing Medical University First Affiliated Hospital Nanjing Jiangsu China

11. Department of Breast and Thyroid Surgery The First Affiliated Hospital of Naval Medical University Shanghai China

12. Department of Medical Oncology Nanchang People's Hospital Nanchang Jiangxi China

13. Department of Medical Oncology Affiliated Jinhua Hospital Zhejiang University School of Medicine Jinhua Zhejiang China

14. Department of General Surgery (Breast and Thyroid Surgery) Shaoxing People's Hospital Shaoxing Hospital Zhejiang University School of Medicine Shaoxing Zhejiang China

15. Department of Surgical Oncology Quzhou Hospital of Zhejiang University Quzhou Zhejiang China

16. Department of Breast Surgery The First Affiliated Hospital of Wenzhou Medical University Wenzhou Zhejiang China

17. Department of Breast and Thyroid Surgery The Affiliated Lihuili Hospital Ningbo University Ningbo Zhejiang China

18. Department of Breast and Thyroid Surgery Taizhou Hospital of Zhejiang Province Affiliated with Wenzhou Medical University Linhai Zhejiang China

19. Department of Medical Oncology Yiwu Hospital Affiliated with Hangzhou Medical College Yiwu Zhejiang China

20. Laboratory for Core Technology of Traditional Chinese Medicine Quality Improvement and Transformation College of Pharmaceutical Science The Third Affiliated Hospital Academy of Chinese Medical Science Zhejiang Chinese Medical University Hangzhou Zhejiang China

21. Department of Oncology Wenzhou Central Hospital Wenzhou Zhejiang China

22. Department of Medical Oncology Shanghai East Hospital School of Medicine Tongji University Shanghai China

23. Department of Breast Center Cancer Center West China Hospital Sichuan University Chengdu Sichuan China

24. Key Laboratory of Respiratory Disease of Zhejiang Province Department of Respiratory and Critical Care Medicine Second Affiliated Hospital of Zhejiang University School of Medicine Cancer Center Zhejiang University Hangzhou Zhejiang China

25. Department of Oncology Lishui Municipal Central Hospital Lishui Zhejiang China

26. Department of Medical Oncology Fudan University Shanghai Cancer Center Shanghai China

27. Department of Respiratory Medicine Affiliated Hospital of Nanjing University of Chinese Medicine Jiangsu Province Hospital of Chinese Medicine Nanjing Jiangsu China

28. Department of Shanghai Lung Cancer Center Shanghai Chest Hospital Shanghai Jiao Tong University Shanghai China

29. Guangdong Lung Cancer Institute Guangdong Provincial Laboratory of Translational Medicine in Lung Cancer Guangdong Provincial People's Hospital Guangdong Academy of Medical Sciences, School of Medicine Guangzhou Guangdong China

30. Lung Cancer and Gastrointestinal Unit Department of Medical Oncology Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine Central South University Changsha Hunan China

31. Department of Respiratory Medicine Affiliated Drum Tower Hospital Medical School of Nanjing University Nanjing Jiangsu China

32. Department of Respiratory Medicine Clinical Medical School of Yangzhou University Subei People's Hospital of Jiangsu Province Yangzhou Jiangsu China

33. Department of Internal Medicine Cancer Center of PLA Qinhuai Medical Area Affiliated Jinling Hospital Medical School of Nanjing University Nanjing Jiangsu China

34. Cancer Center Union Hospital Tongji Medical College Huazhong University of Science and Technology Wuhan Hubei China

35. Department of Thoracic Disease Diagnosis and Treatment Center Zhejiang Rongjun Hospital The Third Affiliated Hospital of Jiaxing University Jiaxing Zhejiang China

36. Department of Pathology Shanxi Academy of Medical Sciences Shanxi Bethune Hospital Taiyuan Shanxi China

37. Department of Respiratory Medicine The Affiliated Jiangning Hospital of Nanjing Medical University Nanjing Jiangsu China

38. Department of Oncology Second Affiliated Hospital of Nanchang University Nanchang Jiangxi China

39. International Cooperative Laboratory of Traditional Chinese Medicine Modernization and Innovative Drug Discovery of Chinese Ministry of Education Guangzhou City Key Laboratory of Precision Chemical Drug Development School of Pharmacy Jinan University Guangzhou Guangdong China

40. Department of Clinical Oncology The 901 Hospital of Joint Logistics Support Force of People Liberation Army Hefei Anhui China

41. Department of Clinical Pathology The First Affiliated Hospital of Jinan University Guangzhou Guangdong China

42. Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing) Department of Melanoma and Sarcoma Peking University Cancer Hospital and Institute Beijing China

Abstract

AbstractAntibody–drug conjugates (ADCs) have demonstrated effectiveness in treating various cancers, particularly exhibiting specificity in targeting human epidermal growth factor receptor 2 (HER2)‐positive breast cancer. Recent advancements in phase 3 clinical trials have broadened current understanding of ADCs, especially trastuzumab deruxtecan, in treating other HER2‐expressing malignancies. This expansion of knowledge has led to the US Food and Drug Administration's approval of trastuzumab deruxtecan for HER2‐positive and HER2‐low breast cancer, HER2‐positive gastric cancer, and HER2‐mutant nonsmall cell lung cancer. Concurrent with the increasing use of ADCs in oncology, there is growing concern among health care professionals regarding the rise in the incidence of interstitial lung disease or pneumonitis (ILD/p), which is associated with anti‐HER2 ADC therapy. Studies on anti‐HER2 ADCs have reported varying ILD/p mortality rates. Consequently, it is crucial to establish guidelines for the diagnosis and management of ILD/p in patients receiving anti‐HER2 ADC therapy. To this end, a panel of Chinese experts was convened to formulate a strategic approach for the identification and management of ILD/p in patients treated with anti‐HER2 ADC therapy. This report presents the expert panel's opinions and recommendations, which are intended to guide the management of ILD/p induced by anti‐HER2 ADC therapy in clinical practice.

Publisher

Wiley

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