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Enhertu (Trastuzumab Deruxtecan) Patient Handout

What is Enhertu?

Enhertu (Trastuzumab Deruxtecan) is a targeted therapy used to treat certain types of cancer, including HER2-positive breast cancer, HER2-low breast cancer, and HER2-positive gastric cancer. It is an antibody-drug conjugate (ADC) that combines a HER2-targeting antibody with a chemotherapy agent, delivering the chemotherapy directly to cancer cells.

How is Enhertu Administered?

  • Enhertu is given as an intravenous (IV) infusion in a hospital or clinic setting.
  • The usual starting dose is 5.4 mg/kg or 6.4 mg/kg, depending on the type of cancer being treated. Your dose will be calculated based on your body weight.
  • Infusions are typically administered every three weeks (21-day cycle).
  • The first infusion may take up to 90 minutes, with subsequent infusions potentially taking 30 minutes if well-tolerated.

Possible Side Effects

Enhertu can cause side effects. Common ones include:

  • Nausea and vomiting
  • Fatigue
  • Low blood cell counts (anemia, neutropenia, or thrombocytopenia)
  • Hair loss
  • Constipation or diarrhea
  • Decreased appetite
  • Cough or difficulty breathing

Less common but serious side effects:

  • Interstitial lung disease (ILD) or pneumonitis (inflammation of the lungs)
  • Severe infections
  • Heart problems, including decreased heart function
  • Liver toxicity (elevated liver enzymes)

If you experience severe or unusual symptoms, contact your healthcare provider immediately.

Precautions Before Starting Enhertu

  • Inform your doctor if you have a history of:
    • Lung problems, such as interstitial lung disease or pneumonitis
    • Heart conditions
    • Liver or kidney problems
    • Any other significant medical conditions
  • Discuss all medications, vitamins, or supplements you are taking.
  • Use effective contraception during treatment and for at least 7 months after the final dose, as Enhertu can harm an unborn baby.
  • Avoid live vaccines during treatment.

Managing Side Effects

  • Nausea and vomiting: Anti-nausea medications may be prescribed. Eat small, bland meals as needed.
  • Low blood counts: Follow precautions to avoid infections, such as frequent handwashing and avoiding sick individuals.
  • Fatigue: Rest as needed and maintain a balanced diet.
  • Lung symptoms: Report any new or worsening cough, shortness of breath, or chest pain immediately.
  • Hair loss: Consider using wigs or head coverings if needed for comfort.

When to Contact Your Physician

  • Immediately:
    • If you experience difficulty breathing, persistent cough, or chest pain.
    • If you notice signs of infection, such as fever or chills.
    • If you develop severe nausea, vomiting, or diarrhea.
  • As soon as possible:
    • If you notice unusual fatigue, yellowing of the skin/eyes (jaundice), or swelling in your legs.
    • If you experience any signs of heart problems, such as shortness of breath or dizziness.

Storage and Handling

  • Enhertu is administered by healthcare professionals and is not stored at home.

Disclaimer: This handout is intended for educational purposes only and does not replace professional medical advice. Always follow the guidance of your healthcare provider regarding your medications and health conditions.