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ANTIBODY-DRUG CONJUGATE TARGETED THERAPY
Enhertu (fam-trastuzumab deruxtecan-nxki) is a prescription medication approved by the U.S. Food and Drug Administration (FDA) to treat adults with certain HER2-positive, HER2-low, or HER2-ultralow breast cancers.
These insights are based on 219 comments about Enhertu from MyBCTeam members. These are the experiences of a small number of individuals and are not meant to be medical advice.
Benefits:
Considerations:
Enhertu is a type of targeted cancer medicine called an antibody-drug conjugate. Human epidermal growth factor receptor 2 (HER2) is a protein found in high amounts on some cancer cells. Enhertu attaches to HER2 on cancer cells and delivers a chemotherapy medicine inside the cell.
This can damage DNA and lead to cell death. In breast cancer, this may help slow the growth of cancer and destroy cancer cells.
Doctors prescribe Enhertu when adults have certain HER2-positive breast cancers, HER2-low breast cancers, or HER2-ultralow breast cancers. The exact use depends on the type of breast cancer, whether it has spread, and which breast cancer treatments were used before.
Enhertu may be used:
Enhertu is given as an intravenous (IV) infusion, usually once every three weeks. The first infusion is given over 90 minutes. Later infusions may be given over 30 minutes if earlier infusions were well tolerated.
How long treatment continues depends on why Enhertu is being used. In some early breast cancer treatment plans, it is given for a set number of cycles. In metastatic breast cancer, it is usually given until the cancer gets worse or side effects become unacceptable.
The recommended dosing of Enhertu for breast cancer may be described in three ways: by itself, with pertuzumab, or before other treatments.
When Enhertu is used by itself:
When Enhertu is used with pertuzumab for HER2-positive metastatic breast cancer, the recommended dose is 5.4 milligrams per kilogram every three weeks.
Treatment continues until the cancer gets worse or side effects become unacceptable.
When Enhertu is used before other treatments:
Your doctor will give you medicines before your infusion to help prevent nausea and vomiting.
Doctors may pause treatment, lower the dose, delay the next dose, slow an infusion, or stop treatment if side effects are serious or hard to manage.
This information is based on the prescribing information, but your healthcare provider may tailor your treatment plan. Always follow their guidance.
These insights are based on 219 comments about Enhertu from MyBCTeam members.
Members who use Enhertu often say it helps to plan around a three-week treatment cycle, keep track of side effects, and stay in close contact with their care team about new symptoms or test results. Many also describe practical ways they cope with fatigue, nausea, appetite changes, and other day-to-day challenges during treatment.
Plan for a recovery week after each infusion.
“Fatigue hits like a brick wall two days after infusion and lasts about one week. I spend the following two weeks catching up on life before the next infusion creeps up on me.”
Stay hydrated and eat small meals if side effects occur.
“I’m on Enhertu as well, and the nausea and tummy aches are insane! Infusion 5 and 6 were manageable — I try to stay hydrated and eat small meals. Hydration is key.”
Talk to your doctor about heart, lung, or blood count changes.
“Because Enhertu caused inflammation in my lungs twice, I was taken off of it 10 months ago. My doctor hasn’t put me back on anything, giving my body a chance to heal.”
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In clinical studies of Enhertu for breast cancer, the most common side effects differed between early breast cancer and metastatic breast cancer. These side effects occurred in at least 20 percent of people taking Enhertu.
For HER2-positive, HER2-low, and HER2-ultralow breast cancer, these side effects include:
For early breast cancer, these side effects include:
For HER2-positive metastatic breast cancer in combination with pertuzumab, these side effects include:
Enhertu can cause serious side effects that may require immediate medical attention, including:
Get medical help right away if you think you are having a serious reaction.
Daiichi Sankyo and AstraZeneca offer the ENHERTU Patient Savings Program. Eligible people with commercial insurance may pay as little as $0 per year for Enhertu out-of-pocket costs.
The savings program is not available if prescriptions are paid by state or federally funded programs, including Medicare Part B, Medicare Part D, Medicaid, Medigap, Veterans Affairs, or TRICARE.
The ENHERTU Patient Savings Program is part of ENHERTU4U, which offers support such as benefits reviews, prior authorization and claims appeal information, and help paying for your prescription.
To learn more, visit the ENHERTU4U affordability page or call 833-364-3788.
Before starting Enhertu, your doctor will test or check:
Tell your doctor about all medicines you take, including prescription drugs, over-the-counter medicines, vitamins, and herbal supplements.
Before you receive Enhertu, tell your doctor if you:
Enhertu is also FDA-approved to treat certain non-small cell lung cancers, gastric cancers, gastroesophageal junction adenocarcinomas, and solid tumors.
If you miss a planned dose of Enhertu, call your doctor right away to schedule an appointment. Do not wait until the next planned treatment cycle.
Enhertu can harm your baby if you are pregnant. Females who can become pregnant should use effective birth control during treatment and for seven months after the last dose. Males with female partners who can become pregnant should use effective birth control during treatment and for four months after the last dose.
Enhertu may cause fertility problems in males. This means it may affect the ability to father a child. Talk to your healthcare provider if you have concerns about fertility.
Do not breastfeed during treatment with Enhertu or for seven months after the last dose.
These answers are fact-checked by our editorial staff.
How effective is Enhertu in breast cancer?
In clinical studies, Enhertu was evaluated in adults with certain types of breast cancer.
In one study, adults with HER2-positive metastatic breast cancer received either Enhertu or ado-trastuzumab emtansine. Metastatic means the cancer has spread to another part of the body.
The median progression-free survival was not reached for people who received Enhertu. This means that at the study analysis, more than half of those taking Enhertu were living without their cancer getting worse. For those who received ado-trastuzumab emtansine, the median progression-free survival was 6.8 months.
Progression-free survival means how long people lived without their cancer getting worse.
In the same study, 82.7 percent of people who received Enhertu had a complete or partial response. This means their tumors disappeared or got smaller. The response rate was 36.1 percent among people who received ado-trastuzumab emtansine.
In another study of adults with HER2-low metastatic breast cancer, the median progression-free survival was 9.9 months with Enhertu and 5.1 months with chemotherapy. In that study, the median overall survival was 23.4 months with Enhertu and 16.8 months with chemotherapy.
Overall survival means how long people lived after starting treatment. These results are from clinical studies and may not predict how well Enhertu will work for each person.
Your doctor can explain what these results may mean for you.
Can Enhertu cause heart problems in people with breast cancer?
Yes. Enhertu can cause a heart problem called left ventricular dysfunction (LVD). This means the heart may not pump blood as well as it should.
Your doctor should check your heart function before you start Enhertu. This is done with a left ventricular ejection fraction (LVEF) test, which measures how well the heart pumps blood. Your doctor may also check your heart during treatment as needed.
Your doctor may pause or stop Enhertu based on your LVEF results. Enhertu should be permanently stopped if you develop symptomatic congestive heart failure. This means heart failure that causes symptoms.
Can Enhertu cause lung problems in people with breast cancer?
Yes. Enhertu can cause serious lung problems called interstitial lung disease (ILD) and pneumonitis. These lung problems can be severe, life-threatening, or fatal.
Tell your doctor right away if you have a new or worsening cough, shortness of breath, fever, or other breathing problems.
Your doctor should check for lung problems during treatment. Enhertu must be permanently stopped if you are diagnosed with symptomatic grade 2 or higher ILD or pneumonitis.
On MyBCTeam, people share their experiences with breast cancer, get advice, and find support from others who understand.
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