{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T08:39:03Z","timestamp":1792658343065,"version":"4.5.0"},"reference-count":29,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T00:00:00Z","timestamp":1785110400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T00:00:00Z","timestamp":1785110400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Asia-Pac J Clncl Oncology"],"published-print":{"date-parts":[[2026,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>In the setting of human epidermal growth factor receptor 2 (HER2)\u2010overexpressing breast cancer, trastuzumab emtansine (T\u2010DM1) is associated with improvements in both relapse\u2010free and overall survival for patients with residual invasive disease after receiving neoadjuvant chemotherapy and HER2\u2010targeted therapy. Many of these patients also undergo adjuvant radiotherapy treatment (RT); however, outside of the KATHERINE trial, there is little published data regarding the safety of this as a concurrent therapy, or when used in close sequential proximity. We report on ten cases at our institution whereby enhanced radiotherapy toxicity was observed when RT was delivered concurrently, or in close proximity to, T\u2010DM1. Five patients experienced significant pulmonary toxicity, including early\u2010onset radiation pneumonitis (RP), recurrent RP despite appropriate treatment, and out\u2010of\u2010field RP. Two patients experienced unexpected enhanced skin toxicity, one with prolonged radiation dermatitis followed by telangiectasia formation and the other with breast cellulitis requiring hospital admission. A further two developed rib fractures, one requiring surgical management and hyperbaric treatment. A final patient developed myositis. This case series supports the hypothesis that T\u2010DM1 may enhance radiation toxicity, potentially due to its microtubule inhibitor emtansine components. Further studies are recommended to assess the potential toxicities and sequencing when combining treatment modalities. We advise clinicians to remain vigilant for unexpected toxicities and consider the potential risks in patient management of adjuvant radiotherapy when combined with T\u2010DM1.<\/jats:p>","DOI":"10.1111\/ajco.70146","type":"journal-article","created":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T04:27:37Z","timestamp":1785212857000},"page":"881-890","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Acute Toxicity With Trastuzumab Emtansine and Concurrent Radiotherapy: Non\u2010Consecutive Case Series"],"prefix":"10.1111","volume":"22","author":[{"given":"Philip","family":"Carroll","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology Peter MacCallum Cancer Centre  Melbourne Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jade","family":"Soo","sequence":"additional","affiliation":[{"name":"Monash Cancer Centre  Melbourne Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keelan","family":"Byrne","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Peter MacCallum Cancer Centre  Melbourne Australia"},{"name":"Sunshine Hospital Radiation Therapy Centre  Melbourne Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle","family":"White","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Peter MacCallum Cancer Centre  Melbourne Australia"},{"name":"Medical Oncology,\u00a0Cabrini Health  Melbourne Australia"},{"name":"Faculty of Medicine Dentistry and Health Sciences, Monash University  Melbourne Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoland","family":"Antill","sequence":"additional","affiliation":[{"name":"Medical Oncology,\u00a0Cabrini Health  Melbourne Australia"},{"name":"Faculty of Medicine Dentistry and Health Sciences, Monash University  Melbourne Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karen","family":"Taylor","sequence":"additional","affiliation":[{"name":"Genesis Cancer Care Victoria  Melbourne Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Tan","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Peter MacCallum Cancer Centre  Melbourne Australia"},{"name":"Monash Cancer Centre  Melbourne Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Phillip","family":"Tran","sequence":"additional","affiliation":[{"name":"Sunshine Hospital Radiation Therapy Centre  Melbourne Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven","family":"David","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Peter MacCallum Cancer Centre  Melbourne Australia"},{"name":"Monash Cancer Centre  Melbourne Australia"},{"name":"Faculty of Medicine Dentistry and Health Sciences, Monash University  Melbourne Australia"},{"name":"Sir Peter MacCallum Department of Oncology The University of Melbourne  Melbourne Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,27]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1814017"},{"key":"e_1_2_11_3_1","unstructured":"Center for Drug Evaluation and Research.FDA Approves Ado\u2010Trastuzumab Emtansine for Early Breast Cancer [Internet]. U.S. Food and Drug Administration FDA;2019[cited 2022 December 19].https:\/\/www.fda.gov\/drugs\/resources\u2010information\u2010approved\u2010drugs\/fda\u2010approves\u2010ado\u2010trastuzumab\u2010emtansine\u2010early\u2010breast\u2010cancer."},{"key":"e_1_2_11_4_1","unstructured":"Cancer Institute New South Wales.eviQ Cancer Treatments Online. Sydney: Cancer Institute of New South Wales; 2021 [cited 2022 December 12].https:\/\/www.eviq.org.au."},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2021.12.173"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ctro.2020.06.013"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1093\/neuonc\/not329"},{"key":"e_1_2_11_8_1","unstructured":"Peter MacCallum Cancer Centre.Digital Health and Learning Systems [Internet]. 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