Enhertu: Revolutionizing HER2-Positive Breast Cancer Treatment and Beyond

Enhertu trastuzumab deruxtecan was given regular approval for the treatment of adults with unresectable or metastatic HER2-positive breast cancer who had previously received an anti-HER2-based regimen in the metastatic setting, neoadjuvant setting, or adjuvant setting and experienced a recurrence during or within six months of finishing treatment. 

The FDA granted accelerated approval for this medication in 2019 based on its rate and duration of response. The FDA has also approved the use of fam-trastuzumab deruxtecan for the treatment of metastatic or unresectable HER2-low breast cancer in patients who had previously undergone chemotherapy for metastatic disease or who experienced a recurrence of the illness during or within six months of concluding adjuvant chemotherapy. 

Global Impact Of Breast Cancer

Breast cancer is the most common cancer worldwide and the second-leading cause of cancer-related mortality. In 2020, the global breast cancer death toll was approximately 685,000, and over two million new cases. Treatment options for people with breast cancer include lumpectomy, mastectomy, radiation, chemotherapy, immune cell therapy, endocrine therapy, and targeted therapy, depending on the kind, size, stage, grade, and sensitivity of the cancer cells. 

However, unresectable or metastatic HER2-low breast cancer that was previously treated with chemotherapy can now be treated with Enhertu (fam-trastuzumab-deruxtecan-nxki). It is the first targeted therapy authorized by the US Food and Drug Administration, which has lately revolutionized the therapeutic paradigm. 

https://www.who.int/news-room/fact-sheets/detail/breast-cancer

Mechanism Of Action

An antibody-drug conjugate directed against HER2 is called Fam-trastuzumab deruxtecan-nxki. The anti-HER2 IgG1 antibody is humanized, the cleavable linker binds the topoisomerase I inhibitor to the antibody, forming a tiny molecule. Trastuzumab deruxtecan is bound to HER2 on tumor cells, after which it is internalized, and lysosomal enzymes cleave the intracellular linker. The membrane-permeable DXd (small molecule) damages DNA and induces apoptosis in cells upon release. 

Dosage And Administration

Enhertu should not be substituted for other medications. It is administered intravenously and requires premedication to prevent chemotherapy-induced nausea and vomiting. The recommended dosage for breast cancer is 5.4mg/kg; for lung cancer, also 5.4mg/kg; and for gastric cancer, 6.4mg/kg. This medicine is available in the form of a lyophilized powder for injection, conveniently provided as Enhertu 100mg single-dose vials. 

Adverse reactions, such as interstitial lung disease, neutropenia, thrombocytopenia, or left ventricular dysfunction, may require dosage adjustments or temporary discontinuation of Enhertu. Before administration, premedication is recommended to prevent chemotherapy-induced nausea and vomiting. 

Recent Research Of Enhertu

• Enhertu is also being investigated in clinical trials for treating HER2-positive metastatic colorectal cancer and HER2-positive metastatic endometrial cancer. The results of these trials are promising, and Enhertu could be approved for the treatment of these cancers in the future.

• Additionally, Enhertu is being studied in combination with other treatments like radiation and immunotherapy. These trials’ first findings are encouraging, implying that Enhertu might be even more beneficial when combined with other treatments.

Common Side Effects

The most common adverse reactions in patients with metastatic breast cancer and HER2-mutant NSCLC include nausea, decreased white blood cell count, and fatigue. Meanwhile, common adverse reactions in patients with gastric cancer encompass decreased hemoglobin, nausea, and fatigue, among others. Close monitoring and management of these potential side effects are essential during Enhertu injection treatment.

Conclusion 
HER2-positive stomach and gastroesophageal junction cancer patients have hope thanks to Trastuzumab deruxtecan. Its accuracy, potency, and tolerable side effects have the potential to transform the game. The success of Enhertu highlights medical innovation in the fight against cancer, generating hopes for better, more individualized treatments. Enhertu price depends on the product requirement. Request more details by contacting our Patient Support Team at ‎(+91) 9315705373 or help@sansfro.com.

Reference: 

1. https://www.accessdata.fda.gov/drugsatfda_docs/label/2022/761139s021lbl.pdf
2. https://www.astrazeneca.com/media-centre/press-releases/2022/enhertu-approved-in-the-us-for-her2-low-mbc.html
3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9577648/ 
4. https://www.nejm.org/doi/full/10.1056/NEJMoa2203690