Oral mucositis secondary to datopotamab deruxtecan for advanced-stage cancer managed with cryotherapy after topical steroid failure: A case series study.

BACKGROUND: Datopotamab deruxtecan (Dato-DXd) is a trophoblast cell surface antigen 2-directed antibody-drug conjugate (ADC) approved for the treatment of unresectable, metastatic, hormone receptor-positive, human epidermal growth factor receptor 2-negative breast cancers, and previously treated metastatic epidermal growth factor receptor-positive non-small cell lung cancers. Despite its considerable success in clinical oncology, ADC therapy can lead to severe adverse events, including oral mucositis (OM), which can negatively affect patients' quality of life and threaten patients' ability to tolerate treatment. Given its impact, a number of strategies have been suggested to mitigate ADC-associated OM, among which is the use of prophylactic topical steroid mouthrinses.

CASE DESCRIPTION: This is a case series of 4 patients with a history of breast and cervical cancers who developed extensive OM lesions secondary to initiation of Dato-DXd. Among the different treatments implemented, topical steroids failed to control the Dato-DXd-induced OM lesions and oral cryotherapy with and without dose reduction alleviated symptoms and prevented new lesions.

PRACTICAL IMPLICATIONS: These findings highlight the need for larger, prospective studies to define optimal management strategies for ADC-induced OM.