{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,2]],"date-time":"2026-02-02T05:18:28Z","timestamp":1770009508339,"version":"3.49.0"},"reference-count":35,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2026,1,27]],"date-time":"2026-01-27T00:00:00Z","timestamp":1769472000000},"content-version":"vor","delay-in-days":10,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,1,17]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Trastuzumab deruxtecan (T-DXd) reshaped clinical practice in human epidermal growth factor receptor 2-positive (HER2+) metastatic breast cancer (mBC). The impact of clinical characteristics and drug\u2013drug interactions (DDIs) on outcomes in patients receiving T-DXd is still under investigation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively analyzed data of patients from the Italian DE-REAL study. Clinical features including age, body mass index (BMI), toxicity and DDIs were assessed and correlated with clinical outcomes. The Drug-PIN software was used to evaluate DDIs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 143 patients, age did not significantly affect progression-free survival (PFS) but influenced overall survival (OS), with younger patients (&amp;lt;65 years) showing better outcomes (median overall survival [mOS]: 12 vs. 10 months, P\u2009=\u20090.02). Patients with BMI &amp;gt;25 demonstrated significantly longer PFS (11 vs. 9 months, P\u2009=\u20090.04), which was confirmed as independent predictor of better PFS at multivariate analysis (P\u2009\u22640.05), but experienced higher toxicity rates, particularly nausea (P\u2009=\u20090.019). Drug-PIN classification showed no impact on survival outcomes, although patients with high-risk DDIs experienced more nausea and asthenia compared to those with low-risk interactions (P\u2009=\u20090.0018 and P\u2009=\u20090.003, respectively).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>T-DXd efficacy appears consistent across different age groups, although elderly patients showed reduced OS. Higher BMI was associated with improved PFS but increased toxicity. While DDIs did not affect survival outcomes, they influenced specific adverse events. Our results reinforce the efficacy and favorable safety profile of T-DXd in a broad real-world population, including patients with polypharmacy or comorbidities, while highlighting that personalized monitoring and supportive care strategies may be particularly beneficial for elderly patients and those with higher BMI.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/oncolo\/oyaf402","type":"journal-article","created":{"date-parts":[[2026,1,19]],"date-time":"2026-01-19T12:20:11Z","timestamp":1768825211000},"source":"Crossref","is-referenced-by-count":0,"title":["Clinical characteristics and drug\u2013drug interactions in human epidermal growth factor receptor 2-positive breast cancer treated with trastuzumab deruxtecan: real-world data from the DE-REAL study"],"prefix":"10.1093","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6910-9528","authenticated-orcid":false,"given":"Simona","family":"Pisegna","sequence":"first","affiliation":[{"name":"Department of Experimental Medicine, Sapienza University of Rome , Rome, 00161,","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4943-5622","authenticated-orcid":false,"given":"Simone","family":"Scagnoli","sequence":"additional","affiliation":[{"name":"Department of Radiological, Oncological and Pathological Science, Sapienza University of Rome , Rome, 00161,","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gabriella","family":"Gentile","sequence":"additional","affiliation":[{"name":"Department of Radiological, Oncological and Pathological Science, Sapienza University of Rome , Rome, 00161,","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antonella","family":"Chiavassa","sequence":"additional","affiliation":[{"name":"Department of Radiological, Oncological and Pathological Science, Sapienza University of Rome , Rome, 00161,","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4231-1184","authenticated-orcid":false,"given":"Roberta","family":"Caputo","sequence":"additional","affiliation":[{"name":"Department of Breast and Thoracic Oncology, Division of Breast Medical Oncology, Istituto Nazionale Tumori IRCCS \u201cFondazione Pascale , Naples, 80131,","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9009-1572","authenticated-orcid":false,"given":"Michelino","family":"De Laurentiis","sequence":"additional","affiliation":[{"name":"Department of Breast and Thoracic Oncology, Division of Breast Medical Oncology, Istituto Nazionale Tumori IRCCS \u201cFondazione Pascale , Naples, 80131,","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1781-2518","authenticated-orcid":false,"given":"Giuseppe","family":"Curigliano","sequence":"additional","affiliation":[{"name":"European Institute of Oncology, IRCCS , Milan, 20141,","place":["Italy"]},{"name":"Department of Oncology and Hemato-Oncology, University of Milan , Milan, 20122,","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1797-5296","authenticated-orcid":false,"given":"Matteo","family":"Lambertini","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Medical Specialties (DiMI), School of Medicine, University of Genova , Genoa, 16132,","place":["Italy"]},{"name":"Department of Medical Oncology, U.O.C. 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