{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T03:59:51Z","timestamp":1777953591363,"version":"3.51.4"},"reference-count":21,"publisher":"S. Karger AG","issue":"5","license":[{"start":{"date-parts":[[2025,8,4]],"date-time":"2025-08-04T00:00:00Z","timestamp":1754265600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/karger.com\/pages\/terms-and-conditions"},{"start":{"date-parts":[[2025,8,4]],"date-time":"2025-08-04T00:00:00Z","timestamp":1754265600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/karger.com\/pages\/terms-and-conditions"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Oncology"],"abstract":"<jats:p>Introduction: The DESTINY-B01 trial led to trastuzumab deruxtecan (T-DXd) approval for human epidermal growth factor receptor-2 (HER2+) metastatic breast cancers (mBCs), with efficacy further confirmed by DESTINY-B03, demonstrating improved progression-free and overall survival versus trastuzumab emtansine. Despite its efficacy, T-DXd had notable adverse events (AEs), including interstitial lung disease, necessitating real-world studies on safety and tolerability. Findings from such studies may help guide treatment selection and inform risk-benefit discussion in routine clinical practice. Methods: A real-world cohort study evaluated the safety and tolerability of T-DXd in patients with HER2+ mBC. De-identified patient data, tumor characteristics, AEs, dose modifications, and discontinuation rates due to AEs were analyzed. Results: Between January 2020 and June 2024, 85 predominantly non-Hispanic white patients with a median age of 57 years were treated. Notably, 17.6% had an ECOG performance status of 2\u20133, 69.4% had 1\u20132 prior metastatic treatments, 94% had visceral involvement, and most received primary prophylaxis with dexamethasone and palonosetron. Approximately 29.4% initiated treatment at a reduced dose; 40% required further dose reductions, primarily due to fatigue (9.4%). Permanent discontinuation due to AEs occurred in 10.6%. Common AEs included fatigue (95.3%), alopecia (14.1%), and peripheral neuropathy (14.1%). Grade \u22653 AEs were infrequent and included neutropenia (10.6%), elevated aspartate aminotransferase (2.4%), elevated alkaline phosphatase (2.4%), and interstitial lung disease (1.2%). No grade 5 events were observed. Conclusion: T-DXd demonstrated acceptable tolerability with manageable AEs in real-world patients with HER2+ mBC, aligning with clinical trial outcomes and supporting its continued use in clinical practice.<\/jats:p>","DOI":"10.1159\/000547685","type":"journal-article","created":{"date-parts":[[2025,8,5]],"date-time":"2025-08-05T16:08:12Z","timestamp":1754410092000},"page":"508-517","source":"Crossref","is-referenced-by-count":0,"title":["A Real-World Single-Center Cohort Study on the Tolerability of Trastuzumab Deruxtecan for HER2+ Metastatic Breast 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