Chiu, Joanne Wing YanJoanne Wing YanChiuLee, Soo ChinSoo ChinLeeHo, James Chung-ManJames Chung-ManHoPark, Yeon HeeYeon HeeParkChao, Ta-ChungTa-ChungChaoKim, Sung-BaeSung-BaeKimLim, ElgeneElgeneLimCHING-HUNG LINLoi, ShereneShereneLoiLow, Su YingSu YingLowTeo, Lynette Li SanLynette Li SanTeoYeo, WinnieWinnieYeoDent, RebeccaRebeccaDent2023-11-152023-11-152023-1001145916https://scholars.lib.ntu.edu.tw/handle/123456789/637133Trastuzumab deruxtecan (T-DXd)-an antibody-drug conjugate targeting the human epidermal growth factor receptor 2 (HER2)-improved outcomes of patients with HER2-positive and HER2-low metastatic breast cancer. Guidance on monitoring and managing T-DXd-related adverse events (AEs) is an emerging unmet need as translating clinical trial experience into real-world practice may be difficult due to practical and cultural considerations and differences in health care infrastructure. Thus, 13 experts including oncologists, pulmonologists and a radiologist from the Asia-Pacific region gathered to provide recommendations for T-DXd-related AE monitoring and management by using the latest evidence from the DESTINY-Breast trials, our own clinical trial experience and loco-regional health care considerations. While subgroup analysis of Asian (excluding Japanese) versus overall population in the DESTINY-Breast03 uncovered no major differences in the AE profile, we concluded that proactive monitoring and management are essential in maximising the benefits with T-DXd. As interstitial lung disease (ILD)/pneumonitis is a serious AE, patients should undergo regular computed tomography scans, but the frequency may have to account for the median time of ILD/pneumonitis onset and access. Trastuzumab deruxtecan appears to be a highly emetic regimen, and prophylaxis with serotonin receptor antagonists and dexamethasone (with or without neurokinin-1 receptor antagonist) should be considered. Health care professionals should be vigilant for treatable causes of fatigue, and patients should be encouraged to use support groups and practice low-intensity exercises. To increase treatment acceptance, patients should be made aware of alopecia risk prior to starting T-DXd. Detailed monitoring and management recommendations for T-DXd-related AEs are discussed further.enreview10.1007/s40264-023-01328-x375524392-s2.0-85167348180https://api.elsevier.com/content/abstract/scopus_id/85167348180