Thrombopoietin Receptor Agonists for Thrombocytopenia Secondary to HER2-Targeted Antibody Drug Conjugates

Oncologist. 2023 Sep 7;28(9):e843-e846. doi: 10.1093/oncolo/oyad185.

Abstract

Trastuzumab emtansine and trastuzumab deruxtecan are widely used in breast cancer and other solid tumor malignancies. Thrombocytopenia is a common adverse event associated with the use of these agents that can lead to a treatment delay, reduction in dose intensity, and discontinuation. The role of thrombopoietin receptor agonists (TPO-RA) remains unknown in this setting. We report a case series of 6 individuals with breast cancer that experienced dose-reductions and therapy delays due to thrombocytopenia secondary to trastuzumab emtansine or trastuzumab deruxtecan therapy and received intervention with TPO-RA. All 6 were able to resume therapy with TPO-RA support.

Keywords: HER2 positive breast cancer; avatrombopag; romiplostim; thrombocytopenia; trastuzumab deruxtecan; trastuzumab emtansine.

MeSH terms

  • Ado-Trastuzumab Emtansine / therapeutic use
  • Anemia* / chemically induced
  • Antibodies, Monoclonal, Humanized / therapeutic use
  • Breast Neoplasms* / drug therapy
  • Breast Neoplasms* / pathology
  • Female
  • Humans
  • Immunoconjugates* / therapeutic use
  • Receptor, ErbB-2 / genetics
  • Receptor, ErbB-2 / therapeutic use
  • Receptors, Thrombopoietin / therapeutic use
  • Thrombocytopenia* / chemically induced
  • Thrombocytopenia* / drug therapy
  • Trastuzumab / adverse effects

Substances

  • Ado-Trastuzumab Emtansine
  • Receptors, Thrombopoietin
  • Receptor, ErbB-2
  • Antibodies, Monoclonal, Humanized
  • Trastuzumab
  • Immunoconjugates