Anti-HER2 antibody-drug conjugate
Trastuzumab deruxtecan (Specialist drug)
Brand names: Enhertu
Adult dose
Dose: Specialist initiation only — refer to BNF/SmPC
Route: IV
Frequency: every 3 weeks
Clinical pearls
- HER2-positive/HER2-low metastatic breast cancer; HER2-positive gastric
- Specialist oncology — pulmonary monitoring
Contraindications
- Severe ILD history
- Severe LV dysfunction
- Pregnancy
- Hypersensitivity
Side effects
- ILD/pneumonitis (boxed — fatalities)
- LV dysfunction
- Cytopenias
- Nausea/vomiting
- Alopecia
Interactions
- Live vaccines
- Strong CYP3A4 inhibitors
Monitoring
- LVEF
- Pulmonary function
- FBC
Reference: BNF; NICE TA704/TA889; SmPC; https://bnf.nice.org.uk/drugs/trastuzumab-deruxtecan-specialist-drug/. Verify against your local formulary and the latest BNF before prescribing.
Related
Curated clinical cross-links plus same-class fallbacks.
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