Treatment-related toxicities of antibody-drug conjugates in breast cancer: A Bayesian network meta-analysis.

• DOI: 10.1200/jco.2025.43.16_suppl.e15015
• Publication Date: 2025-05-28T15:26:18Z
• Authors: Yiqun Han; Yuan Yao; Yucai Wang; Yoshito Nishimura; Yi Lin; Meng Xu Welliver; Kathryn Jean Ruddy; Robert Mutter
• Keywords: Antibody-drug conjugate; Cancer drugs

e15015 Background: Antibody-drug conjugates (ADCs) have demonstrated significant efficacy in treating patients with breast cancer. However, the toxicity variations between these agents are not yet thoroughly elucidated. This study aims to systematically compare profiles of various ADCs used cancer therapy better inform clinical decision-making. Methods: We conducted a systematic review randomized controlled trials (RCTs) published by September 2024. Treatment-related adverse events (TRAEs) investigational and standard care control were classified into systemic categories based on Common Terminology Criteria for Adverse Events. Bayesian models employed facilitate indirect comparisons TRAEs associated different reported using surface under cumulative ranking curve (SUCRA) values. The protocol was prospectively registered PROSPERO (CRD42024606194). Results: A total 9307 17 RCTs five (ado-trastuzumab emtansine [T-DM1], sacituzumab govitecan [SG], trastuzumab deruxtecan [T-DXd], datopotamab [Dato-DXd], ARX788) included. SG T-DXd monotherapy highest risk neutropenia/anemia, SUCRA values 11.2%/26.7%, 20.7%/17.1%, respectively. T-DM1-containing regimens had incidence thrombocytopenia, which exacerbated when combined chemotherapy compared monotherapy. In terms gastrointestinal (GI) toxicities, diarrhea, followed comparable risks T-DM1 anti-HER2 dual therapy. relatively higher vomiting (9.5%), while nausea seen T-DXd. more likely cause fatigue, decreased appetite, dermatological disorders, including alopecia, rash, pruritus, therapies linked pyrexia. also related liver function test abnormalities, musculoskeletal neurological disorders. Dato-DXd fatigue ARX788 least hematological GI TRAEs. Conclusions: network meta-analysis highlights variability among primarily thrombocytopenia hepatic neutropenia, anemia, Our findings may help selection ADC cancer, facilitating personalized approaches minimize treatment-related toxicities.