Breast Cancer Research and Treatment

, Volume 146, Issue 2, pp 451–456

Ado-trastuzumab emtansine-associated telangiectasias in metastatic breast cancer: a case series


  • Vincent Sibaud
    • Department of dermatologyInstitut Claudius Regaud, Institut Universitaire Cancer Toulouse-oncopole
  • Rachel E. Niec
    • Weill Cornell Medical College, Tri-Institutional MD PhD Program
  • Katja Schindler
    • Department of DermatologyMedical University of Vienna
    • Dermatology ServiceMemorial Sloan-Kettering Cancer Center
  • Klaus J. Busam
    • Department of Pathology, Human Oncology and Pathogenesis ProgramMemorial Sloan-Kettering Cancer Center
  • Henri Roché
    • Department of oncologyInstitut Claudius Regaud, Institut Universitaire Cancer Toulouse-Oncopole
  • Shanu Modi
    • Breast Oncology ServiceMemorial Sloan-Kettering Cancer Center
  • Jean Pierre Delord
    • Department of oncologyInstitut Claudius Regaud, Institut Universitaire Cancer Toulouse-Oncopole
    • Dermatology ServiceMemorial Sloan-Kettering Cancer Center
Brief Report

DOI: 10.1007/s10549-014-3001-z

Cite this article as:
Sibaud, V., Niec, R.E., Schindler, K. et al. Breast Cancer Res Treat (2014) 146: 451. doi:10.1007/s10549-014-3001-z


Treatment of HER2-positive metastatic breast cancer with ado-trastuzumab emtansine (T-DM1), a novel antibody–drug conjugate, has resulted in both improved progression-free and overall survival. Recognition and treatment of diverse adverse events related to T-DM1 is critical for safety and tolerability. The most frequent adverse events with T-DM1 include fatigue, diarrhea, anemia, elevated transaminases, and mild-to-moderate hemorrhagic events, which are thought to be related to induced thrombocytopenia. Here, we present five case series of cutaneous and mucosal telangiectasias, definitely related to T-DM1. The development of telangiectasias represents a newly recognized adverse effect of T-DM1. We provide description and timing of the telangiectasias and review the mechanisms that may explain the formation of these vascular lesions in association with T-DM1. Further, we describe associated bleeding events and propose that induced telangiectasias could represent an additional cause of T-DM1-associated hemorrhage.


Ado-trastuzumab emtansineBreast cancerHemorrhageT-DM1TelangiectasiaThrombocytopeniaSpider nevus



Ado-trastuzumab emtansine


Hereditary hemorrhagic telangiectasia


Immune thrombocytopenia purpura


Not applicable


Upper limit of normal

Copyright information

© Springer Science+Business Media New York 2014