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Trastuzumab deruxtecan (Enhertu) is an antibody drug conjugate approved to treat people with metastatic, HER2-positive, hormone receptor-negative breast cancer that has grown after at least two past treatments.

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How trastuzumab deruxtecan works

Trastuzumab deruxtecan is an antibody drug conjugate. This type of treatment uses a targeted therapy, in this case trastuzumab, to direct the treatment to cancer cells, and pairs it with a chemotherapy medicine to kill the cancer cells.

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Who gets trastuzumab deruxtecan

The Food and Drug Administration approved trastuzumab deruxtecan to treat metastatic, HER2-positive breast cancer that has grown after at least two past lines of HER2-targeted treatment for metastatic breast cancer. These include common therapies like trastuzumab (Herceptin or biosimilar) and ado-trastuzumab emtansine (Kadcyla).

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How trastuzumab deruxtecan is given

Trastuzumab deruxtecan is given by vein once every 3 weeks at your doctor’s office or infusion center. Your care team determines the dose by your weight, and you’ll get it over about 30 minutes (90 minutes for your first infusion). Treatment can continue until the cancer grows or spreads to other parts of the body or you and your doctor decide to stop because of side effects.

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Side effects and things to remember

In the clinical studies of trastuzumab deruxtecan, the people who took part reported these common side effects that you may experience

In rare cases, some people developed a very serious lung condition called interstitial lung disease. On scans, this disease looks like scarring or inflammation of the lungs. This condition can be fatal. You should report any lung problems you have while taking this medicine to your doctor immediately, including

  • cough
  • trouble breathing
  • shortness of breath
  • fever

Like other HER2-targeting medicines, trastuzumab deruxtecan can also affect your heart function. Your doctor will watch for problems in your heart, but let them know if you have symptoms such as sudden weight gain, swelling, dizziness, or if you faint.

Trastuzumab deruxtecan may be dangerous to a fetus if taken during or before a pregnancy. You should not take it if you are pregnant or breastfeeding, and you should take steps to avoid getting pregnant while on trastuzumab deruxtecan. Men taking trastuzumab deruxtecan should also take steps to avoid getting their partner pregnant.

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Reviewed and updated: March 25, 2021

Reviewed by: Tiffany Avery MD MPH

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Living Beyond Breast Cancer is a national nonprofit organization that seeks to create a world that understands there is more than one way to have breast cancer. To fulfill its mission of providing trusted information and a community of support to those impacted by the disease, Living Beyond Breast Cancer offers on-demand emotional, practical, and evidence-based content. For over 30 years, the organization has remained committed to creating a culture of acceptance — where sharing the diversity of the lived experience of breast cancer fosters self-advocacy and hope. For more information, learn more about our programs and services.

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