What is Enhertu?
Enhertu is a newer treatment for managing a specific type of breast cancer known as HER2-positive breast cancer.
These cancer types are prevalent and about one in five women suffer from it. The name comes from the protein HER2 on cancer cells. These cells tend to spread and grow aggressively.
Enhertu works by targeting the HER2 protein and releasing a chemotherapy agent to destroy cancer cells.
How to use Enhertu?
Enhertu Label Uses
Enhertu or fam-trastuzumab deruxtecan-nxki is a prescription medication used to treat certain types of breast cancer (HER2-positive) that cannot be removed by surgery or spread to other parts of the body after at least two different types of breast cancer treatment.
So, it is used for HER2-positive breast cancers that are metastatic or unresectable.
The drug is also used to treat a certain type of gastric cancer (cancer of the stomach), mainly in adults that have spread to adjacent tissues or other parts of the body after receiving another treatment.
Enhertu Off-label Use
There is no off-label use of the medicine so far.
Enhertu may be prescribed for other uses; ask your doctor or pharmacist for more information.
Enhertu Dosage and Directions for Use
- Enhertu is available as 100 mg lyophilized powder in a single-dose vial.
- The powder is to be mixed with liquid and is to be used intravenous infusion only. Do not administer as an intravenous push or bolus.
- The drug is to be administered by a nurse or doctor in a hospital or medical facility. The first infusion may take over 90 minutes, and the following infusions may take around 30 minutes. The infusion rate depends upon how you tolerate your current infusion. The recommended Enhertu dose is 5.4 mg/kg for breast cancer and 6.4 mg/kg for gastric cancer. The drug is to be injected as an intravenous infusion once every three weeks for as long as your doctor recommends that you receive treatment or until disease progression or unacceptable toxicity.
- In case of adverse events, the dose may be discontinued temporary, dose reduction can happen, or treatment discontinuation depending upon the severity of an adverse event. Your treating doctor will take the call. Talk to you your doctor about how you feel during the treatment.
- If your planned dose is missed or delayed, administer as soon as possible. Do not wait until the next scheduled cycle. Adjust the subsequent cycles to 21 days from the day of administration. Keep a gap of 3 weeks between two doses.
How to store and dispose of Enhertu?
The vials are to be stored in the refrigerator at 2ºC to 8ºC in the original carton. The vials are to be protected from direct sunlight until the time of reconstitution.
Do not freeze the reconstituted solution. Also, do not shake or dilute the reconstituted solution.
Active Ingredient: Fam-trastuzumab deruxtecan-nxki
It belongs to the antibody and topoisomerase inhibitor conjugate class of medication. This means it has an antibody and chemotherapy part. It mainly causes DNA damage and apoptotic cell death (killing of cancer cells).
Fam-trastuzumab deruxtecan-nxki does so by the following actions:
- The antibody part of the chemical finds and attaches to the HER2 receptor on cancer cells
- Once attached to the targeted cells, it releases the chemotherapy part that destroys the cancer cells.
Enhertu Side Effects
Like all the medications, Enhertu also has side effects. It is possible that you may experience the following side effects;
- Dry eyes
- Stomach ache
- Nose bleeding
- Loss of hair
- Loss of appetite
- Sore lips, mouth, or throat
Some of these effects can be serious. If you experience any of the following symptoms, please get in touch with your physician immediately or get emergency medical treatment:
- Pale skin
- Shortness of breath
- Unusual bleeding
- Unusual bruising
- Swelling of ankles or legs
- Weight gain
- Irregular heartbeat
- Worsening of shortness of breath
This is not a complete list of side effects. If you experience severe side effects or symptoms that are persistent, please contact your doctor immediately.
Inform your healthcare provider in case of an allergy to Enhertu or any other medication, medications made from Chinese hamster ovary cell protein, or any of the ingredients in Enhertu. Ask your pharmacist or check the medication guide for a list of the ingredients.
Do not take or inform your doctor if you have or had following conditions;
- Heart failure
- Heart disease
- Interstitial lung disease
- Hepatic impairment
- Renal impairment
Besides, inform your doctor if you are pregnant or breastfeeding or planning to be pregnant. You should use appropriate birth control tools while you are on treatment with Enhertu and seven months after your last dose. You should not breastfeed during the treatment and for seven months after the final dose. If you are male, you and your partner should use birth control tools during the treatment and four months after the last dose. Talk to your physician about the best suitable birth control method. Enhertu may cause fetal damage when administered to pregnant females.
Enhertu may cause decreased fertility in men. Talk to your physician about the risk associated with the therapy.
Enhertu Warnings and Precautions
Your doctor may request you to undergo a blood count before initiation of treatment and may continue to do so during the treatment regime.
Your physician would ask you for a regular left ventricular function assessment. In case of symptomatic congestive heart failure, it would result in discontinuation of the treatment.
Females should undergo regular check-ups for pregnancy as Enhertu may cause fetal damage.
Inform your health worker about other prescription and non-prescription medications that you are taking. Also, inform about vitamins, herbal and nutritional supplements that you are taking or planning to take.
The following drugs may interact with Enhertu. Please consult or inform your physician if you are or about to take the following medications;
- Potassium chloride
- Vitamin D
This is not a complete list of medications that interact with Enhertu. You should consult your physician if you are to initiate a new treatment regime.
What Are the Benefits of Enhertu?
Enhertu is a combined medicine for HER2-positive breast cancer with an antibody and chemotherapy component. The antibody component attaches to the cell, and the chemotherapy component destroys them.
It may also be helpful for some metastatic stomach cancers.
Is There A Generic Version?
No. For now, there is no generic version of Enhertu available in Canada.
How Is This Medication Different from Others In The Treatment Of Ailment?
Enhertu is one of its kind combination medicine that includes an antibody part and a chemotherapy part.
What Are the Benefits?
Studies have shown that Enhertu could remove a tumor in patients with metastatic or unresectable breast cancer. About 61% of the women in the studies had the mentioned benefit.
Who Makes This Drug and What Is Their Manufacturing Record of Success?
AstraZeneca, a science-led global biopharmaceutical company, makes Enhertu. They have a deep-rooted heritage in oncology and almost launched six new medicines within six years.