The Drug-Induced Cardiotoxicity Website and App

Frequency - Incidence

Incidence of cardiac adverse event(s) due to the specific drug as assessed by number of reported/published cases in the literature. Red digits in stars indicate: 0 = Very rare, questionable signal · 1 = < 10 cases · 2 = 10-50 cases · 3 = 50–100 cases · 4 = 100-200 cases · 5 = >200 cases

Evidence level/grade

Evidence level for cardiac adverse event(s) due to the specific drug as estimated using Hill’s (1965), Naranjo’s (1981), and Bégaud’s (1985) criteria applied to published cases. Blue digits in stars indicate: 0 = Questionable · 1 = Low · 2 = Moderate · 3 = Robust · 4 = Definite · 5 = Unquestionable, pathognomonic

XXIV.a

Pneumonitis (interstitial lung disease/ILD)

A recently described complication with high incidence and potential severity

Publications

Licata L, Patanè F, Guarino A, Galbardi B, Battaglia A, Mariani M, Zanibelli C, Notini G, Naldini MM, Bosi C, Chiavassa A, Piras M, Persano I, Rognone A, Sica L, Zambelli S, Zucchinelli P, Viale G, Bianchini G

Low Rates of Discontinuation Unrelated to Disease Progression with Trastuzumab Deruxtecan in Metastatic Breast Cancer: A Real-World Study.

Cancers. 2026;18(17)

Sagawa T, Hirakawa M, Nagashima H, Fujikawa K

Trastuzumab Deruxtecan (T-DXd) in HER2-Positive Advanced Gastric and Gastroesophageal Junction Cancer: Evidence, Sequencing, Patient Selection, and Clinical Decision-Making.

Journal of gastrointestinal cancer. 2026;57(1)

Attia AM, Delgado JCT, Lecaros Zavalla AD, Medina KB, Flores Hernandez IA, Villarreal EJ, Faiz SA, Shroff GS, Meric-Bernstam F, Lim B, Altan M, Sheshadri A

Trastuzumab Deruxtecan-Associated Pneumonitis in Non-Breast Solid Tumors: A Retrospective Cohort Study.

Journal of immunotherapy and precision oncology. 2026;9(4):130-140

Tsurutani J, Noguchi K, Tanabe A

Real-world analysis of interstitial lung disease/pneumonitis in Japanese patients with breast cancer receiving trastuzumab deruxtecan.

Breast cancer (Tokyo, Japan). 2026;33(2):346-358

Azhar M, Soto F, Su A, Gonzalez NAV, Medina KB, Madrigal AL, Duran CC, Reyna CIR, Chan C, Shroff GS, Bassett RL, Pasyar S, Zhang D, Shannon VR, Altan M, Mitchell MP, Meric-Bernstam F, Mouabbi J, Murthy RK, Faiz SA, Bashoura L, Lim B, Sheshadri A

Incidence and risk factors for pneumonitis due to trastuzumab Deruxtecan in metastatic breast cancer: a retrospective cohort study.

Breast cancer research : BCR. 2025;27(1):197

Alanazi AS, Alanazi AA, Alanizi A, Babalghaith R, Alotaibi R, Alnuhait M, Bakhribah H

Trastuzumab Deruxtecan-Associated Interstitial Lung Disease: Real-World Insights from a Tertiary Care Center.

Current oncology (Toronto, Ont.). 2025;32(10)

Saura C, Modi S, Krop I, Park YH, Kim SB, Tamura K, Iwata H, Tsurutani J, Sohn J, Mathias E, Liu Y, Cathcart J, Singh J, Yamashita T

Trastuzumab deruxtecan in previously treated patients with HER2-positive metastatic breast cancer: updated survival results from a phase II trial (DESTINY-Breast01).

Annals of oncology : official journal of the European Society for Medical Oncology. 2024;35(3):302-307

Nishino M, Kusumoto M, Bankier AA, Kurihara Y, Zhang L, Rasheed Z, Meinhardt G, Arunachalam M, Taitt C, Wang Q, Powell CA

Trastuzumab Deruxtecan‒Related Interstitial Lung Disease/Pneumonitis: Computed Tomography Imaging Patterns to Guide Diagnosis and Management.

JCO precision oncology. 2023;7:e2300391

Wekking D, Porcu M, Pellegrino B, Lai E, Mura G, Denaro N, Saba L, Musolino A, Scartozzi M, Solinas C

Multidisciplinary clinical guidelines in proactive monitoring, early diagnosis, and effective management of trastuzumab deruxtecan (T-DXd)-induced interstitial lung disease (ILD) in breast cancer patients.

ESMO open. 2023;8(6):102043

Baba T, Kusumoto M, Kato T, Kurihara Y, Sasaki S, Oikado K, Saito Y, Endo M, Fujiwara Y, Kenmotsu H, Sata M, Takano T, Kato K, Hirata K, Katagiri T, Saito H, Kuwano K

Clinical and imaging features of interstitial lung disease in cancer patients treated with trastuzumab deruxtecan.

International journal of clinical oncology. 2023;28(12):1585-1596

Powell CA, Modi S, Iwata H, Takahashi S, Smit EF, Siena S, Chang DY, Macpherson E, Qin A, Singh J, Taitt C, Shire N, Camidge DR

Pooled analysis of drug-related interstitial lung disease and/or pneumonitis in nine trastuzumab deruxtecan monotherapy studies.

ESMO open. 2022;7(4):100554

Abuhelwa Z, Alloghbi A, Alqahtani A, Nagasaka M

Trastuzumab Deruxtecan-Induced Interstitial Lung Disease/Pneumonitis in ERBB2-Positive Advanced Solid Malignancies: A Systematic Review.

Drugs. 2022;82(9):979-987

Cortés J, Kim SB, Chung WP, Im SA, Park YH, Hegg R, Kim MH, Tseng LM, Petry V, Chung CF, Iwata H, Hamilton E, Curigliano G, Xu B, Huang CS, Kim JH, Chiu JWY, Pedrini JL, Lee C, Liu Y, Cathcart J, Bako E, Verma S, Hurvitz SA, DESTINY-Breast03 Trial Investi

Trastuzumab Deruxtecan versus Trastuzumab Emtansine for Breast Cancer.

The New England journal of medicine. 2022;386(12):1143-1154

Lee J, Park YH

Trastuzumab deruxtecan for HER2+ advanced breast cancer.

Future oncology (London, England). 2022;18(1):7-19

Li BT, Smit EF, Goto Y, Nakagawa K, Udagawa H, Mazières J, Nagasaka M, Bazhenova L, Saltos AN, Felip E, Pacheco JM, Pérol M, Paz-Ares L, Saxena K, Shiga R, Cheng Y, Acharyya S, Vitazka P, Shahidi J, Planchard D, Jänne PA, DESTINY-Lung01 Trial Investigator

Trastuzumab Deruxtecan in HER2-Mutant Non-Small-Cell Lung Cancer.

The New England journal of medicine. 2022;386(3):241-251

Modi S, Saura C, Yamashita T, Park YH, Kim SB, Tamura K, Andre F, Iwata H, Ito Y, Tsurutani J, Sohn J, Denduluri N, Perrin C, Aogi K, Tokunaga E, Im SA, Lee KS, Hurvitz SA, Cortes J, Lee C, Chen S, Zhang L, Shahidi J, Yver A, Krop I, DESTINY-Breast01 Inve

Trastuzumab Deruxtecan in Previously Treated HER2-Positive Breast Cancer.

The New England journal of medicine. 2020;382(7):610-621

Shitara K, Iwata H, Takahashi S, Tamura K, Park H, Modi S, Tsurutani J, Kadowaki S, Yamaguchi K, Iwasa S, Saito K, Fujisaki Y, Sugihara M, Shahidi J, Doi T

Trastuzumab deruxtecan (DS-8201a) in patients with advanced HER2-positive gastric cancer: a dose-expansion, phase 1 study.

The Lancet. Oncology. 2019;20(6):827-836

Tamura K, Tsurutani J, Takahashi S, Iwata H, Krop IE, Redfern C, Sagara Y, Doi T, Park H, Murthy RK, Redman RA, Jikoh T, Lee C, Sugihara M, Shahidi J, Yver A, Modi S

Trastuzumab deruxtecan (DS-8201a) in patients with advanced HER2-positive breast cancer previously treated with trastuzumab emtansine: a dose-expansion, phase 1 study.

The Lancet. Oncology. 2019;20(6):816-826