Side Effects to Know About for Enhertu in HER2-Positive Solid Tumors

After the Food and Drug Administration approved Enhertu (fam-trastuzumab deruxtecan-nxki) for patients with HER2-positive solid tumors, an expert spoke with CURE® about the potential side effects.

The approval, which is the “first drug ever” for patients with different types of HER2-positive solid tumors, was quite “unprecedented,” said Dr. Sarah Sammons.

This is the first “tumor agnostic” approval for HER2-positive solid tumors defined as having strong immunohistochemistry HER2 staining of three plus, “which is really exciting,” she said.

Sammons is a medical oncologist and associate director of the metastatic breast cancer program at Dana-Farber Cancer Institute in Boston.

As with all cancer treatments, Enhertu also causes certain side effects. During an interview with CURE®, Sammons discussed some of the side effects patients may experience with Enhertu and what they should know moving forward.


When I’m counseling a patient about Enhertu, I tell them that it’s quite common to experience nausea. And we actually give, with the infusion, three different drugs to help mitigate that nausea. Then, we’re making sure that patients go home with some sort of anti-emetic or anti-nausea medication, such as [Zofran (ondansetron)] or Compazine (prochlorperazine) or something like that.

Nausea is very common fatigue is quite common, and a little bit of alopecia or hair loss is also common with the drug. We also have to monitor blood counts, which is fairly common for other types of intravenous chemotherapy as well, because we can see some neutropenia, a little bit of anemia, which we’re usually able to manage quite well in the clinic.

One very important area that I think is important to counsel patients on is that the drug has a 10% to 15% risk of inflammation of the lungs, which the medical term for that is called pneumonitis. Signs of pneumonitis would be cough and shortness of breath. Those are really the main ones, worsening fatigue. And so, if a patient develops a new cough, any shortness of breath or the cough is usually nonproductive, then we have a really high index of suspicion that it could be a side effect of the drug and we generally do a CT scan.

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