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Sergio Cifuentes Canaval

Aug 5, 2025, 10:08

Sergio Cifuentes Canaval: A Pooled Analysis of 9 Clinical Trials

Sergio Cifuentes Canaval, Medical Oncologist, ASCO International Development and Education Award (IDEA) Recipient – 2025 at Conquer Cancer, the ASCO Foundation, shared a post on LinkedIn:

“T-DXd Retreatment After Grade 1 ILD/Pneumonitis

A pooled analysis of 9 clinical trials (N=2,145) provides the most comprehensive data to date on trastuzumab deruxtecan (T-DXd) retreatment following grade 1 ILD/pneumonitis. These findings have important implications for optimizing therapy in HER2-positive/Low-expressing cancers:

Key Safety and Efficacy Insights

Retreatment Feasibility:
Among patients with resolved grade 1 ILD (193/2145), 23.3% (45/193) were successfully retreated with T-DXd.
Median retreatment duration: 85 days (range: 1-848), with 17.8% continuing ≥1 year – demonstrating durable benefit in a subset.
ILD Recurrence Profile:
33.3% (15/45) experienced recurrent ILD (all Grade 1-2; no ≥Grade 3 events).
Median time to recurrence: 64 days (range: 22-391) – underscoring need for vigilant imaging follow-up.
60% of recurrences resolved with standard management (per guidelines).
CT Monitoring is Critical:
The analysis reinforces that early radiographic detection (via scheduled CT scans) enables:
1. Timely intervention for recurrent ILD
2. Safer retreatment protocols
3. Distinction between progression vs. inflammatory changes

Why This Matters for Clinical Practice

Expands therapeutic options for patients who derive benefit from T-DXd but develop manageable ILD.
Supports risk-adapted strategies: With close imaging surveillance, retreatment can be considered for select patients after Grade 1 ILD resolution.
Real-world relevance: Aligns with growing experience that not all ILD requires permanent discontinuation.”

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