{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T19:11:25Z","timestamp":1791659485404,"version":"4.3.4"},"reference-count":37,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T00:00:00Z","timestamp":1769904000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T00:00:00Z","timestamp":1769904000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["acsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2026,2,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Although trastuzumab deruxtecan (T\u2010DXd) demonstrated unprecedented intracranial efficacy in HER2\u2010positive breast cancer brain metastases (BCBM), its association with interstitial lung disease (ILD)\/pneumonitis posed a critical safety concern in this high\u2010risk population. Previous safety assessments lacked BCBM\u2010specific analysis of ILD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This systematic review and meta\u2010analysis (PROSPERO identifier CRD420251130832) followed Preferred Reporting Items for Systematic Reviews and Meta\u2010Analyses guidelines. The authors searched the PubMed, Embase, Web of Science, and Cochrane databases and major oncology conferences through July 2025 for studies that reported T\u2010DXd\u2010related, treatment\u2010emergent adverse events (TEAEs) in patients with HER2\u2010positive BCBM, focusing on ILD\/pneumonitis incidence and severity. Pooled rates were calculated using random effects models.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In total, nine studies involving 684 patients with BCBM were included. The\u00a0pooled incidence rates for all\u2010grade and grade \u22653 ILD\/pneumonitis were 10%\u00a0(95% confidence interval [CI], 5%\u201316%) and 2% (95% CI, 1%\u20134%), respectively. ILD\/pneumonitis led to discontinuation in 11% (95% CI, 0%\u201324%) of patients with BCBM. No fatal ILD events were reported. Overall, any\u2010grade TEAEs occurred in 97% of patients, with grade \u22653 TEAEs occurring in 48%. Fatigue and nausea were the most prevalent all\u2010grade TEAEs, with incidences of 67% and 60%, respectively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In patients with BCBM, T\u2010DXd\u2013associated ILD\/pneumonitis occurred in 10% of patient and frequently necessitated treatment modification. Although no fatal ILD was observed, the high discontinuation rate underscored the imperative for vigilant monitoring and protocol\u2010guided management to mitigate pulmonary toxicity while preserving intracranial efficacy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cncr.70268","type":"journal-article","created":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T11:00:40Z","timestamp":1769943640000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["The safety of trastuzumab deruxtecan (T\u2010DXd) in breast cancer brain metastases with a focus on interstitial lung disease\/pneumonitis: A systematic review and meta\u2010analysis"],"prefix":"10.1002","volume":"132","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-6289-1021","authenticated-orcid":false,"given":"Yiwen","family":"Ma","sequence":"first","affiliation":[{"name":"Department of Oncology Cancer Hospital of Dalian University of Technology 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