In this episode of the Oncology Brothers podcast, we wrapped up our three-part CME series on HER2-positive biliary tract cancer. Drs. Rahul & Rohit Gosain focused on a crucial topic: managing adverse events associated with treatment. We were joined by Dr. Rachna Shroff, who previously discussed toxicity monitoring in pancreatic cancer.
We began by reviewing the treatment landscape for biliary tract cancer, including the importance of biomarker testing for actionable mutations like IDH1, FGFR alterations, and HER2. In our previous episodes, we explored available treatment options, and in this episode, we dived into the practical aspects of managing side effects from the two approved agents: T-DXd and Zanidatamab.
Dr. Shroff highlighted that while T-DXd is a significant advancement, it carries risks, particularly interstitial lung disease (ILD), which we must monitor closely. We discussed the importance of recognizing and managing common side effects such as nausea, vomiting, diarrhea, and anemia, as well as the potential for dose reductions to mitigate these effects.
Shifting to Zanidatamab, we noted that its side effects are generally more manageable, with diarrhea being the most common concern. Dr. Shroff emphasized the need for proactive management strategies to prevent severe diarrhea and infusion-related reactions, which can be alarming for patients.
Throughout the episode, we stressed the importance of patient education and shared decision-making, especially given the palliative intent of treatment in metastatic settings. We also touched on the need for regular monitoring of ejection fraction when using anti-HER2 agents.
As we concluded, we reiterated the significance of biomarker testing and effective side effect management to ensure our patients can remain on these vital treatments longer. Thank you for joining us, and be sure to check out our other episodes. We are the Oncology Brothers.