A meta-analysis of the incidence of treatment-related adverse events (TRAEs) with an ADC class drug in patients with metastatic breast cancer [10] showed that the most common TRAEs associated with sacituzumab govitecan (SG) were hematological toxicities and gastrointestinal adverse events. The most frequent grade 3 or higher adverse events were neutropenia (46%), anemia (10%), and diarrhea (7%) [11]. Compared to chemotherapy, the incidence of these events was significantly higher [12, 13].
A meta-analysis of hepatic toxicity associated with ADC class drugs in breast cancer [14] found that the incidence of any-grade alanine aminotransferase (ALT) and aspartate aminotransferase (AST) elevation with SG was 25.30% and 20.19%, respectively, while the incidence of grade 3 or higher elevations was 1.50% and 1.05%.
A meta-analysis of the incidence of fatigue associated with ADC class drugs in breast cancer showed that the incidence of any-grade fatigue with SG was 47.05%, and the incidence of grade 3 or higher fatigue was 4.82%. This rate was lower than that of T-DXd but higher than that of T-DM1.
In a meta-analysis evaluating the safety of datopotamab deruxtecan (Dato-DXd) [15], the most common grade 3-4 adverse events were stomatitis (13.88%), fatigue (4.16%), and vomiting (1.38%).