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Multi-organ irAE Benefit — SCE Medical Oncology MCQ

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HardMelanoma & SkinMulti-organ irAE BenefitSCE Medical Oncology

A patient receiving trastuzumab deruxtecan has new ground-glass change on CT but no respiratory symptoms; MDT review classifies this as grade 1 drug-related ILD. What is the SmPC-aligned action?

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Correct answer: E — Interrupt to grade 0; use the 28-day point to choose the resumption dose

Grade 1 ILD requires interruption until fully resolved to grade 0 and prompt consideration of corticosteroids. If it resolves within 28 days, treatment may resume at the same dose; if later, resume one dose level lower. Continuing during active ILD is unsafe, while mandatory permanent discontinuation applies to symptomatic grade 2 or worse disease, not every grade 1 event.

Reference: Enhertu 100 mg UK SmPC. https://www.medicines.org.uk/emc/product/12135/smpc