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Assessing safety concerns of interstitial lung disease associated with antibody-drug conjugates: a real-world pharmacovigilance evaluation of the FDA adverse event reporting system

Background: Antibody-drug conjugates have revolutionized cancer therapy due to their selectivity and efficacy. However, concerns have been raised regarding the potential effects of trastuzumab deruxtecan in interstitial lung diseases.

Aim: This study aimed to investigate the safety signals and time to onset of antibody-drug conjugates induced interstitial lung disease.

Method: We utilized the FDA Adverse Event Reporting System database (2004-2022) to identify interstitial lung disease safety signals in 13 FDA-approved antibody-drug conjugates. Disproportionality analysis was conducted to estimate the reporting odds ratios for interstitial lung disease.

Results: Seven antibody-drug conjugates exhibited safety signals of interstitial lung disease: trastuzumab deruxtecan [reporting odds ratio, ROR (95% confidence intervals, CI) = 64.15 (57.07-72.10)], enfortumab vedotin [ROR (95% CI) = 5.24 (3.25-8.43)], trastuzumab emtansine [ROR (95% CI) = 3.62 (2.90-4.53)], brentuximab vedotin [ROR (95% CI) = 3.22 (2.49-4.17)], polatuzumab vedotin [ROR (95% CI) = 2.56 (1.59-4.12)], gemtuzumab ozogamicin [ROR (95% CI) = 2.53 (1.70-3.78)], and inotuzumab ozogamicin [ROR (95% CI) = 2.33 (1.21-4.49)]. Five antibody-drug conjugates with limited reports were excluded from further analysis: belantamab mafodotin, loncastuximab tesirine, mirvetuximab sorafenib, tisotumab vedotin, and moxetumomab pasudotox. Japan and the United States were the primary reporting countries.

Conclusion: This real-world study highlights high safety signals of interstitial lung disease associated with antibody-drug conjugates. Clinicians should be aware of these safety concerns and risk factors and implement early identification measures for their patients. Future research should prioritize comprehensively exploring the relationship between antibody-drug conjugates and lung diseases.

 

Comments:

Your study seems comprehensive in evaluating the safety signals and time to onset of interstitial lung diseases associated with various FDA-approved antibody-drug conjugates. Highlighting seven ADCs with significant safety signals for interstitial lung disease brings attention to potential risks associated with these medications.

The identification of primary reporting countries, Japan and the United States, provides a geographical insight into where these adverse events are being reported more frequently. It emphasizes the need for global awareness and monitoring of these safety concerns among healthcare providers.

The conclusion rightly emphasizes the importance of clinician awareness regarding these safety signals, encouraging early identification and monitoring of potential lung-related adverse events in patients receiving these ADCs. It also emphasizes the necessity for further research to thoroughly investigate the relationship between antibody-drug conjugates and lung diseases, potentially exploring risk factors and mechanisms underlying these adverse effects.

Has your study sparked any subsequent research or changes in clinical practice guidelines?

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E2851 Trastuzumab-Emtansine(T-DM1) Trastuzumab Emtansine(T-DM1,Ado-Trastuzumab emtansine) is an antibody-drug conjugate (ADC) that incorporates the HER2-targeted antitumor properties of trastuzumab with the cytotoxic activity of the microtubule-inhibitory agent DM1.Trastuzumab emtansine has a molecular weight of 145kDa.This product is supplied as 10mg/ml PBS solution. This product is discontinued. We recommend the replacement products: D4003

Related Targets

Microtubule Associated HER2 Antibody-Drug Conjugate