Key Discussion Points: Previous meta-analyses on the safety of Trop2-ADC drugs in breast cancer have primarily focused on the safety of individual drugs such as SG or Dato-DXd, without comparing different Trop2-ADC drugs. This study pools safety data from various clinical trials to determine the incidence rates of different adverse events and indirectly compares the safety of different Trop2-ADC drugs through the analysis of RCTs.
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TRAEs (Treatment-Related Adverse Events): In this study, Dato-DXd demonstrated superior safety in terms of grade 3 or higher TRAEs, TRAEs leading to death, and SAEs (Serious Adverse Events) both in absolute incidence rates and in the results of network meta-analysis compared to other Trop2-ADC drugs.
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Hematological Toxicity: Hematological toxicity is the most common TRAE associated with SG. In this study, the hematological toxicity profile of Dato-DXd was significantly better than that of SG and SKB264, which may be related to the payload deruxtecan.
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Non-Hematological Toxicity: This study updates the safety data of Trop2-ADC drugs by including more studies. Among these, the incidence of grade 3 or higher stomatitis with Dato-DXd treatment was 7.06%, slightly lower than that of SKB264 and ranking better in comparison. For gastrointestinal symptoms (such as vomiting and nausea), the incidence of grade 3 or higher vomiting and nausea with Dato-DXd treatment was slightly higher than with SG; diarrhea remains the most common grade 3 or higher gastrointestinal adverse reaction with SG. However, due to the lack of corresponding data for Dato-DXd and SG, a direct comparison of the superiority of different Trop2-ADC drugs in terms of diarrhea could not be made. Regarding hepatotoxicity, the safety profile of SKB264 appears to be inferior to that of SG, suggesting the need for liver function monitoring during treatment.
