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
  • Rachel E. Niec
  • Katja Schindler
  • Klaus J. Busam
  • Henri Roché
  • Shanu Modi
  • Jean Pierre Delord
  • Mario E. Lacouture
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

Abstract

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.

Keywords

Ado-trastuzumab emtansineBreast cancerHemorrhageT-DM1TelangiectasiaThrombocytopeniaSpider nevus

Abbreviations

T-DM1

Ado-trastuzumab emtansine

HHT

Hereditary hemorrhagic telangiectasia

ITP

Immune thrombocytopenia purpura

NA

Not applicable

ULN

Upper limit of normal

Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Vincent Sibaud
    • 1
  • Rachel E. Niec
    • 2
  • Katja Schindler
    • 3
    • 7
  • Klaus J. Busam
    • 4
  • Henri Roché
    • 5
  • Shanu Modi
    • 6
  • Jean Pierre Delord
    • 5
  • Mario E. Lacouture
    • 7
  1. 1.Department of dermatologyInstitut Claudius Regaud, Institut Universitaire Cancer Toulouse-oncopoleToulouseFrance
  2. 2.Weill Cornell Medical College, Tri-Institutional MD PhD ProgramNew YorkUSA
  3. 3.Department of DermatologyMedical University of ViennaViennaAustria
  4. 4.Department of Pathology, Human Oncology and Pathogenesis ProgramMemorial Sloan-Kettering Cancer CenterNew YorkUSA
  5. 5.Department of oncologyInstitut Claudius Regaud, Institut Universitaire Cancer Toulouse-OncopoleToulouseFrance
  6. 6.Breast Oncology ServiceMemorial Sloan-Kettering Cancer CenterNew YorkUSA
  7. 7.Dermatology ServiceMemorial Sloan-Kettering Cancer CenterNew YorkUSA