Open AccessSinusoidal obstruction syndrome post-treatment with trastuzumab emtansine (T-DM1) in advanced breast cancer
Author(s) -
Yasutoshi Fujii,
Mihoko Doi,
Naofumi Tsukiyama,
Yui Hattori,
K. Ohya,
Noriyuki Shiroma,
Kei Morio,
Takehiko Morioka,
Hiroshi Aikata,
Kazuo Shinozaki,
Kazuaki Chayama
Publication year - 2019
Publication title -
international cancer conference journal
Language(s) - English
Resource type - Journals
ISSN - 2192-3183
DOI - 10.1007/s13691-019-00392-4
Subject(s) - medicine , trastuzumab emtansine , portal hypertension , gastroenterology , breast cancer , trastuzumab , metastatic breast cancer , cancer , oncology , cirrhosis
Trastuzumab emtansine (T-DM1) is an antibody-drug conjugate approved for use in the treatment of human epidermal growth factor receptor 2-positive metastatic breast cancer. Here, we present the cases of two patients with metastatic breast cancer who received T-DM1 monotherapy and developed noncirrhotic portal hypertension (NCPH). Patient 1 presented with ruptured gastric varices at 2 years and 5 months after T-DM1 treatment. Patient 2 presented with intrahepatic portal-hepatic venous shunt at 2 years and 6 months and portal-systemic shunt encephalopathy at 4 years and 11 months after T-DM1 treatment. In both the patients, liver biopsies revealed sinusoidal obstruction syndrome (SOS). T-DM1-induced hepatotoxicity can result from SOS. In long-term administration of T-DM1 the unfavorable events associated with chronic liver circulatory disorder due to SOS, such as NCPH, are concerning.