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General Medication Fact Sheet for Enhertu
| Field | Information |
|---|---|
| Medication Name | Enhertu |
| Generic Name | Trastuzumab deruxtecan |
| Boxed/Label Warning | Interstitial Lung Disease (ILD) and Embryo-Fetal Toxicity |
| Purpose | HER2-directed antibody and topoisomerase inhibitor conjugate indicated for certain HER2-positive cancers. |
| Mechanism of Action | Binds to HER2-expressing cancer cells, is internalized, and releases a topoisomerase I inhibitor (DXd), causing DNA damage and cell death. |
| Dosage Forms | Lyophilized powder for intravenous infusion |
| Available Strengths | 100 mg |
| Dosage Frequency | Every 3 weeks (21-day cycle) |
| Common Side Effects | Nausea, fatigue, vomiting, alopecia, constipation, decreased appetite, anemia, neutropenia, thrombocytopenia |
| Serious Side Effects | Interstitial Lung Disease (ILD), pneumonitis, cardiac dysfunction (decreased left ventricular ejection fraction), embryo-fetal toxicity, infusion-related reactions, neutropenia |
| Drug Interactions | No formal drug interaction studies have been conducted. |
| Important Notes | Monitor for signs and symptoms of ILD/pneumonitis; assess cardiac function prior to and during treatment; use effective contraception during treatment and for at least 7 months after the last dose. |
| Storage | Store vials in a refrigerator at 2°C to 8°C (36°F to 46°F) until time of use. |
| Missed Dose | Contact your doctor immediately to reschedule your appointment. Do not attempt to administer a missed dose on your own. |
| Alternatives | T-DM1 (Kadcyla), Fam-trastuzumab deruxtecan-nxki (Enhertu), Trastuzumab (Herceptin) in combination with other chemotherapy agents, Lapatinib (Tykerb) in combination with capecitabine. |
Enhertu Alternatives
| Medication | Mechanism of Action | Notes |
|---|---|---|
| T-DM1 (Kadcyla) | HER2-targeted antibody-drug conjugate that delivers a cytotoxic agent (DM1) to HER2-positive cells. | Indicated for HER2-positive, metastatic breast cancer in patients who have received prior treatment with trastuzumab and a taxane. |
| Trastuzumab (Herceptin) + Chemotherapy | HER2-targeted antibody that inhibits HER2 signaling and recruits immune cells to kill HER2-positive cancer cells. | Often used in combination with chemotherapy for HER2-positive breast cancer. |
| Lapatinib (Tykerb) + Capecitabine | Tyrosine kinase inhibitor that targets HER2 and EGFR. Capecitabine is a chemotherapy agent. | Used in combination for HER2-positive, metastatic breast cancer in patients who have progressed on prior trastuzumab therapy. |
Enhertu Side Effects
| Common Side Effects | Serious Side Effects |
|---|---|
| Nausea | Interstitial Lung Disease (ILD)/Pneumonitis |
| Fatigue | Cardiac Dysfunction (Decreased LVEF) |
| Vomiting | Neutropenia (Low White Blood Cell Count) |
| Alopecia (Hair Loss) | Thrombocytopenia (Low Platelet Count) |
| Constipation | Infusion-Related Reactions |
| Decreased Appetite | Embryo-Fetal Toxicity |
Enhertu Dosage Guide
| Condition | Starting Dose | Maintenance Dose | Administration Notes |
|---|---|---|---|
| HER2-positive Breast Cancer (Metastatic) | 5.4 mg/kg | 5.4 mg/kg every 3 weeks | Administered as an intravenous infusion. Premedication may be required to reduce infusion-related reactions. |
| HER2-positive Gastric or Gastroesophageal Junction (GEJ) Adenocarcinoma (Metastatic) | 6.4 mg/kg | 6.4 mg/kg every 3 weeks | Administered as an intravenous infusion. Premedication may be required to reduce infusion-related reactions. |
Enhertu Price With And Without Insurance
| Purchase Context | Estimated Price |
|---|---|
| With Insurance | $100 – $500 |
| Without Insurance (U.S.) | $13,000 – $15,000 |
| From CPS | $3,843 |