{
  "abstract": "Purpose: Trastuzumab deruxtecan (T-DXd) has shown remarkable efficacy in phase III trials in patients with HER2-positive early- and late-stage breast cancer and HER2-low/ultra-low metastatic breast cancer (mBC). However, toxicities remain prevalent and clinically relevant, leading to dose reductions/interruptions or discontinuation.\n\nMethods: A survey was conducted across oncologists in 13 countries worldwide to collect experiences in managing T-DXd-related toxicities, focusing on nausea/vomiting, fatigue, and interstitial lung disease (ILD) as key areas of clinical concern.\n\nResults: Ninety-nine experts participated in the survey. Nausea and fatigue were the most common toxicities, reported by 91.9% and 94.9% of respondents, respectively. 5-HT3 receptor antagonists, NK1 receptor antagonists, and corticosteroids were “very often” prescribed for prophylaxis. The frequency of use of second‑generation 5‑HT3 receptor antagonists varied among respondents. Most frequently, they employed an NK1 receptor antagonist combined with corticosteroids and 5‑HT3 receptor antagonists. Forty-four percent of respondents prescribed 4‑drug regimens incorporating NK1 receptor antagonists and olanzapine to all patients with nausea/vomiting above grade 1 in the first cycle, 35% reserved them for high‑risk patients, and 21% used them for all patients from cycle one. For all respondents, patients receiving T‑DXd experienced fatigue, with 65% observing it in more than 60% of patients, and most considered nausea/vomiting and fatigue to moderately or significantly affect daily activities and quality of life. ILD was reported as rare or occasional and was generally monitored using computed tomography.\n\nConclusion: Real-life management of T-DXd-related toxicities is complex and needs an ongoing comprehensive evaluation of patients before, during and after therapy, with a highly trained/skilled multidisciplinary team.\n\nSupplementary Information: The online version contains supplementary material available at https://doi.org/10.1007/s00520-026-11393-4.",
  "abstract_shown": true,
  "affiliations": [
    "Phase 1 Research Centre, Fondazione IRCCS San Gerardo Dei Tintori, Monza, MB Italy",
    "School of Medicine and Surgery, University of Milano-Bicocca, Monza, MB Italy",
    "Genolier Cancer Center, Clinique de Genolier, Genolier, Switzerland",
    "Department of Medical Oncology, Hospital Universitario 12 de Octubre, Madrid, Spain",
    "Instituto de Investigación Sanitaria Hospital 12 de Octubre (Imas12), Madrid, Spain",
    "Department of Nursing, Cyprus University of Technology, Limassol, Cyprus",
    "Medical Oncology, Azienda USL-IRCCS Reggio Emilia, Reggio Emilia, Italy",
    "Department of Medical and Surgical Sciences, University of Modena and Reggio Emilia, Modena, Italy",
    "Medical Oncology Department, Unidade Local de Saúde Santa Maria, Lisbon, Portugal",
    "Gulbenkian Institute for Molecular Medicine, Lisbon, Portugal",
    "Faculty of Medicine, University of Lisbon, Lisbon, Portugal",
    "University Hospital Erlangen, Comprehensive Cancer Center Erlangen-EMN, Department of Gynecology and Obstetrics, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany",
    "Translational Genomics and Targeted Therapies in Solid Tumors, August Pi I Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain",
    "Department of Radiation Oncology, Hospital Clinic de Barcelona, Barcelona, Spain",
    "Department of Medical Oncology, Lyon University Hospital, HCL, Lyon, France",
    "Université de Lyon, Lyon, France",
    "Royal College of Surgeons in Ireland (RCSI), Dublin, Ireland",
    "Department of Pharmacy, Gifu University Hospital, 1-1 Yanagido, Gifu, 501-1194 Japan",
    "Cancer Center, Gifu University Hospital, 1-1 Yanagido, Gifu, 501-1194 Japan",
    "Bartholomew’s Hospital, London, UK",
    "National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences, Beijing, China",
    "City of Hope, Atlanta, GA USA",
    "Department of Medicine, Division of Hematology Oncology, University of California San Diego, San Diego, CA USA",
    "Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea",
    "Department of Medical Oncology and Therapeutics Research, City of Hope Comprehensive Cancer Center, Duarte, CA USA",
    "Advanced Cancer Translational Research Institute, Showa Medical University, Tokyo, Japan",
    "Hoch Health Ostschweiz St. Gallen, St. Gallen, Switzerland",
    "University of Bern, Bern, Switzerland",
    "Cancer Fatigue Clinic (Schaffhausen, Münsterlingen, Sargans), St. Gallen, Switzerland",
    "Facultat de Medicina I Ciencias de La Salut, Universitat de Barcelona (UB), Barcelona, Spain",
    "Department of Hematology Oncology, Pontificia Universidad Católica de Chile, Santiago, Chile",
    "Sun Yat-Sen University, Guangzhou, China"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 21,
  "authors": [
    {
      "affs": [
        0,
        1
      ],
      "name": "Marina Elena Cazzaniga"
    },
    {
      "affs": [
        2
      ],
      "name": "Matti Aapro"
    },
    {
      "affs": [
        3,
        4
      ],
      "name": "Manuel Alva Bianchi"
    },
    {
      "affs": [
        5
      ],
      "name": "Andreas Charalambous"
    },
    {
      "affs": [
        6,
        7
      ],
      "name": "Laura Cortesi"
    },
    {
      "affs": [
        8,
        9,
        10
      ],
      "name": "Luis Costa"
    },
    {
      "affs": [
        11
      ],
      "name": "Peter Fashing"
    },
    {
      "affs": [
        12,
        13
      ],
      "name": "Ana Belen Rodriguez Garcia"
    },
    {
      "affs": [
        14,
        15
      ],
      "name": "Freyer Gilles"
    },
    {
      "affs": [
        16
      ],
      "name": "Bryan Hennessy"
    },
    {
      "affs": [
        17,
        18
      ],
      "name": "Hirotoshi Iihara"
    },
    {
      "affs": [
        19
      ],
      "name": "Maria Lapuente"
    },
    {
      "affs": [
        20
      ],
      "name": "Fei Ma"
    },
    {
      "affs": [
        21
      ],
      "name": "Irati Rodriguez Matesanz"
    },
    {
      "affs": [
        22
      ],
      "name": "Kelly Elizabeth McCann"
    },
    {
      "affs": [
        23
      ],
      "name": "Yeon Hee Park"
    },
    {
      "affs": [
        24
      ],
      "name": "Hope S. Rugo"
    },
    {
      "affs": [
        25
      ],
      "name": "Hitomi Sakai"
    },
    {
      "affs": [
        26,
        27,
        28
      ],
      "name": "Florian Strasser"
    },
    {
      "affs": [
        12,
        29,
        30
      ],
      "name": "Benjamin Walbaum"
    },
    {
      "affs": [
        31
      ],
      "name": "Shusen Wang"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/fpm419f2tkyc9.bib",
  "cited_by": 0,
  "doi": "10.1007/s00520-026-11393-4",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13723672/",
  "id": "fpm419f2tkyc9",
  "issns": [
    "0941-4355",
    "1433-7339"
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  "landing_url": "https://doi.org/10.1007/s00520-026-11393-4",
  "language": "en",
  "licence": "CC-BY-NC-ND-4.0",
  "licence_label": "CC BY-NC-ND 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Research"
    ],
    [
      "openalex",
      "2730|HER2/EGFR in Cancer Research"
    ]
  ],
  "openalex": "W7225016205",
  "pdf_url": "https://link.springer.com/content/pdf/10.1007/s00520-026-11393-4.pdf",
  "pmcid": "PMC13723672",
  "pmid": "42965705",
  "published": "2026-10-31",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/fpm419f2tkyc9.ris",
  "sources": [
    {
      "first_seen": "2026-11-04T12:22:16Z",
      "native_id": "PMC13723672",
      "source": "pmc",
      "url": "https://doi.org/10.1007/s00520-026-11393-4"
    }
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  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2730|HER2/EGFR in Cancer Research",
      "subfield": "oncology"
    }
  ],
  "title": "Managing trastuzumab deruxtecan-related adverse events in patients with metastatic breast cancer: insights from a worldwide survey of the Hermione EDUcational project",
  "title_text": "Managing trastuzumab deruxtecan-related adverse events in patients with metastatic breast cancer: insights from a worldwide survey of the Hermione EDUcational project",
  "type": "peer-reviewed",
  "updated_at": "2026-11-05T12:20:26Z",
  "url": "https://research.draconitic.com/paper/fpm419f2tkyc9",
  "venue": "Supportive Care in Cancer",
  "versions": []
}