New study introduces a simple blood test to detect early lung damage in cancer patients receiving novel therapy with antibody–drug conjugates (ADCs), which can sometimes cause serious, even fatal, lung disease (ILD). By analyzing specific markers in circulating DNA, this test provides a non-invasive way to monitor patients for lung complications without relying solely on imaging scans. This advancement is important because it could help doctors detect and manage  damage sooner, improving safety for patients on powerful cancer drugs and making ongoing monitoring easier and more accessible.

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A team of researchers led by Dr. Albert Grinshpun from the Sharett Institute of Oncology at Hadassah-Hebrew University Medical Center and Dr. Ori Fridlich from Center for Liquid Biopsy at the Department of Pediatric Hemato-Oncology, Hadassah-Hebrew University Medical Center have applied a novel blood test that can detect early signs of potentially fatal lung damage in cancer patients taking antibody–drug conjugates (ADCs). This breakthrough method aims to offer a safer, simpler way to monitor patients for drug-induced lung disease, potentially reducing the need for frequent scans.

ADCs, including the widely used cancer drug Enhertu (trastuzumab deruxtecan), represent a new wave of targeted therapies. However, these drugs can sometimes cause interstitial lung disease (ILD)—a serious condition that can lead to significant lung damage if left untreated. This study demonstrates that by analyzing specific markers in blood samples, doctors can spot early signs of lung damage caused by these drugs. This concept is based on the seminal work originated by Prof. Yuval Dor and Ruth Shemer from the Faculty of Medicine, The Hebrew University.

In this study, researchers retrospectively examined blood from patients with metastatic HER2-positive cancers who were treated with Enhertu and a minority of them developed lung damage during Enhertu treatment. By analyzing these samples, the team detected markers of lung damage that matched symptoms confirmed by medical imaging.

“ADCs and other novel cancer therapies are powerful treatments, but monitoring their side effects can be complex,” said Dr. Grinshpun. “This blood test could offer a low-cost, non-invasive way to detect lung damage early on, helping patients get timely care without relying solely on scans.”

This discovery offers a new approach for monitoring lung health in patients taking ADCs, providing a promising, accessible option for early detection and monitoring. The research team aims to develop this method further for broader clinical use.

The research paper titled “Detection of antibody–drug conjugate-induced interstitial lung disease using circulating cell-free DNA” is now available at ESMO Open and can be accessed at https://www.esmoopen.com/article/S2059-7029(24)01485-6/fulltext

 DOI: 10.1016/j.esmoop.2024.103715

Researchers:

A. Grinshpun^1,2,3, A. Zick^1,3, T. Perri^3,4, A. Naim¹, P. Tarantino^5,6, S.M. Tolaney^5,6, J. Magenheim⁷, O. Fridlich⁸ 

Institution:

1. Sharett Institute of Oncology, Hadassah-Hebrew University Medical Center, Jerusalem
2. Hadassah Cancer Research Institute and Wohl Institute for Translational Medicine, Hadassah-Hebrew University Medical Center, Jerusalem
3. The Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem
4. Department of Gyneco-Oncology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
5. Breast Oncology Program, Dana-Farber Brigham Cancer Center, Boston
6. Harvard Medical School, Boston, USA
7. Department of Developmental Biology and Cancer Research, Institute for Medical Research Israel-Canada, The Hebrew University-Hadassah Medical School, Jerusalem
8. Center for Liquid Biopsy at the Department of Pediatric Hemato-Oncology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel

The Hebrew University of Jerusalem is Israel’s premier academic and research institution. With over 23,000 students from 90 countries, it is a hub for advancing scientific knowledge and holds a significant role in Israel’s civilian scientific research output, accounting for nearly 40% of it and has registered over 11,000 patents. The university’s faculty and alumni have earned eight Nobel Prizes, two Turing Awards a Fields Medal, underscoring their contributions to ground-breaking discoveries. In the global arena, the Hebrew University ranks 81st according to the Shanghai Ranking. To learn more about the university’s academic programs, research initiatives, and achievements, visit the official website at http://new.huji.ac.il/en