title: Ado-trastuzumab emtansine-associated telangiectasias in metastatic breast cancer: a case series.
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.
authors.affiliation: Department of dermatology, Institut Claudius Regaud, Institut Universitaire Cancer Toulouse-oncopole, Toulouse, France.
authors.forename: Vincent
authors.initials: V
authors.lastname: Sibaud
authors.forename: Rachel E
authors.initials: RE
authors.lastname: Niec
authors.forename: Katja
authors.initials: K
authors.lastname: Schindler
authors.forename: Klaus J
authors.initials: KJ
authors.lastname: Busam
authors.forename: Henri
authors.initials: H
authors.lastname: Roché
authors.forename: Shanu
authors.initials: S
authors.lastname: Modi
authors.forename: Jean Pierre
authors.initials: JP
authors.lastname: Delord
authors.forename: Mario E
authors.initials: ME
authors.lastname: Lacouture
mesh_terms: D000080044:Ado-Trastuzumab Emtansine; D000328:Adult; D000368:Aged; D061067:Antibodies, Monoclonal, Humanized / Q000009:adverse effects* / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000150:complications* / Q000188:drug therapy / Q000473:pathology; D005260:Female; D006801:Humans; D008453:Maytansine / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D008875:Middle Aged; D009362:Neoplasm Metastasis; D012867:Skin / Q000473:pathology; D013684:Telangiectasis / Q000175:diagnosis / Q000209:etiology*; D000068878:Trastuzumab
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D000970:Antineoplastic Agents; D008453:Maytansine; D000068878:Trastuzumab; D000080044:Ado-Trastuzumab Emtansine