{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,30]],"date-time":"2025-09-30T00:06:38Z","timestamp":1759190798738,"version":"3.44.0"},"reference-count":38,"publisher":"Wiley","issue":"18","license":[{"start":{"date-parts":[[2025,9,26]],"date-time":"2025-09-26T00:00:00Z","timestamp":1758844800000},"content-version":"vor","delay-in-days":25,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Thoracic Cancer"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:p>Trastuzumab deruxtecan (T\u2010DXd) significantly improves outcomes in HER2\u2010positive or low metastatic breast cancer (MBC), but systematic documentation of its myotoxicity is lacking. A 45\u2010year\u2010old woman with HER2\u2010low MBC and normal body composition (BMI 22.9\u2009kg\/m<jats:sup>2<\/jats:sup>, visceral adipose area [VAT] 69.1\u2009cm<jats:sup>2<\/jats:sup>) developed T\u2010DXd myopathy. She experienced dysphagia, Grade III myalgia, and creatine kinase (CK) peak of 1755\u2009U\/L, with MRI confirming lumbar subcutaneous edema and paraspinal muscle swelling. T\u2010DXd was discontinued. Supportive therapy included hydration, urine alkalization by sodium bicarbonate, glutathione, and magnesium isoglycyrrhizinate. By Day 8, CK decreased to 539\u2009U\/L with myalgia improvement. After 13\u2009days off therapy, CK rebounded to 1735\u2009U\/L with Grade III myalgia, which resolved upon reinitiating support. This case report presents the first documented instance of severe T\u2010DXd\u2010related myopathy in a patient with normal body composition. The observed case outcomes suggest that the combination of glutathione and magnesium isoglycyrrhizinate could potentially reduce CK levels and alleviate T\u2010DXd\u2010associated muscle pain. However, the observed clinical efficacy is based on an individual case. Extrapolation of these clinical outcomes requires large\u2010scale randomized controlled trials with rigorous covariate adjustment.<\/jats:p>","DOI":"10.1111\/1759-7714.70168","type":"journal-article","created":{"date-parts":[[2025,9,27]],"date-time":"2025-09-27T04:28:36Z","timestamp":1758947316000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Trastuzumab Deruxtecan\u2010Induced Myotoxicity: First Case Report About Myopathy in Patient With Normal Body Composition and Clinical Insights"],"prefix":"10.1111","volume":"16","author":[{"given":"Zhen","family":"Qiao","sequence":"first","affiliation":[{"name":"Department of Breast Surgery Zhuhai Center For Maternal and Child Health Care (Zhuhai Women and Children's Hospital)  Zhuhai China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"LiuDan","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Breast Surgery Zhuhai Center For Maternal and Child Health Care (Zhuhai Women and Children's Hospital)  Zhuhai China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hong","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Breast Surgery Zhuhai Center For Maternal and Child Health Care (Zhuhai Women and Children's Hospital)  Zhuhai China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"ShuHui","family":"Dai","sequence":"additional","affiliation":[{"name":"Department of Nursing Zhuhai Center For Maternal and Child Health Care (Zhuhai Women and Children's Hospital)  Zhuhai China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"LiTong","family":"Ye","sequence":"additional","affiliation":[{"name":"Hospital Infection Control Department Zhuhai Center For Maternal and Child Health Care (Zhuhai Women and Children's Hospital)  Zhuhai China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,9,26]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(22)02420-5"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12282-024-01600-7"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1158\/1078-0432.CCR-15-2822"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejmech.2019.111682"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1248\/cpb.c18-00744"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.esmoop.2023.101613"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1586\/1744666X.2016.1103181"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/mus.10244"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.3233\/JND-170282"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.3390\/cancers13071649"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.esmoop.2023.102043"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2015.65.7916"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.esmoop.2024.104083"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1373\/clinchem.2011.171496"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/mus.28114"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(78)92894-5"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/0009-2797(87)90085-8"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtho.2024.05.373"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1734-1140(11)70601-6"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12038-020-00055-0"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40170-022-00286-9"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.21873\/anticanres.14519"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.21873\/anticanres.17364"},{"key":"e_1_2_9_25_1","unstructured":"Pubchem \u201c1\u2010[(2R 3aS 7aS)\u20102\u2010(5\u2010Methyl\u20101 2 4\u2010Oxadiazol\u20103\u2010yl)\u20103 3a 4 5 7 7a\u2010Hexahydro\u20102H\u2010furo[2 3\u2010c]pyridin\u20106\u2010yl]\u20102\u2010(5\u2010Fluoropyridin\u20102\u2010yl)Ethanone \u201d2025 https:\/\/pubchem.ncbi.nlm.nih.gov\/compound\/131682096."},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.devcel.2023.01.007"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1021\/acsnano.5c05477"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41523-025-00754-7"},{"key":"e_1_2_9_29_1","doi-asserted-by":"publisher","DOI":"10.1097\/00003246-200210000-00006"},{"key":"e_1_2_9_30_1","doi-asserted-by":"publisher","DOI":"10.1159\/000515584"},{"issue":"3","key":"e_1_2_9_31_1","first-page":"204","article-title":"Magnesium Isoglycyrrhizinate Prevention of Chemotherapy\u2010Induced Liver Damage During Initial Treatment of Patients With Gastrointestinal Tumors","volume":"23","author":"Yan Y.","year":"2015","journal-title":"Zhonghua Gan Zang Bing Za Zhi"},{"key":"e_1_2_9_32_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12876-025-03600-z"},{"key":"e_1_2_9_33_1","doi-asserted-by":"publisher","DOI":"10.1093\/jn\/135.7.1818S"},{"key":"e_1_2_9_34_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijms25021314"},{"key":"e_1_2_9_35_1","doi-asserted-by":"publisher","DOI":"10.2147\/DDDT.S296405"},{"key":"e_1_2_9_36_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41420-023-01613-9"},{"key":"e_1_2_9_37_1","doi-asserted-by":"publisher","DOI":"10.1016\/bs.vh.2022.09.002"},{"key":"e_1_2_9_38_1","doi-asserted-by":"publisher","DOI":"10.3389\/fphar.2022.806787"},{"key":"e_1_2_9_39_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(17)30604-6"}],"container-title":["Thoracic Cancer"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/1759-7714.70168","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,29]],"date-time":"2025-09-29T09:17:58Z","timestamp":1759137478000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/1759-7714.70168"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9]]},"references-count":38,"journal-issue":{"issue":"18","published-print":{"date-parts":[[2025,9]]}},"alternative-id":["10.1111\/1759-7714.70168"],"URL":"https:\/\/doi.org\/10.1111\/1759-7714.70168","archive":["Portico"],"relation":{},"ISSN":["1759-7706","1759-7714"],"issn-type":[{"type":"print","value":"1759-7706"},{"type":"electronic","value":"1759-7714"}],"subject":[],"published":{"date-parts":[[2025,9]]},"assertion":[{"value":"2025-07-08","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-09-13","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-09-26","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70168"}}