Among patients treated with HER2-directed ADCs, there was more than double the risk of developing both any-grade and Grade ≥ 3 ILD compared with controls receiving the standard-of-care therapies lapatinib plus chemotherapy, or trastuzumab alone or in combination with pertuzumab and/or chemotherapy (Peto odds ratio 2.62 [95% CI 1.71, 4.04], p < 0.0001, and 2.82 [95% CI 1.07, 7.42], p = 0.04, respectively) [33]. This evidence concerns the gene ERBB2 and interstitial lung disease.