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English Brand Name & Chinese Name
ENHERTU^®; 優赫得^®凍晶注射劑

Drug Introduction
Trastuzumab deruxtecan is an antibody–drug conjugate (ADC) that combines a monoclonal antibody with a small-molecule cytotoxic drug, specifically designed to target and kill tumor cells.
Currently, the Taiwan Ministry of Health and Welfare has approved its indications for the treatment of:

1. Unresectable or metastatic HER2-positive breast cancer
2. Unresectable or metastatic HER2-low breast cancer
3. Locally advanced or metastatic HER2-positive gastric cancer or gastroesophageal junction adenocarcinoma
4. Unresectable or metastatic non-small cell lung cancer (NSCLC) with HER2 gene mutation

How Is It Administered?
The first infusion should be administered intravenously over at least 90 minutes. The duration, intervals, and number of subsequent infusions are determined by the physician’s clinical judgment.

Precautions Before and During Administration

• Before starting treatment, inform your doctor if you have any of the following conditions:
  • Kidney disease
  • Lung or respiratory disease
  • Heart disease
• Trastuzumab deruxtecan may lower white blood cell counts, increasing the risk of infection. During treatment, avoid crowded places, maintain good personal hygiene, and seek medical attention promptly if you develop fever, chills, sore throat, or flu-like symptoms.
• It may also cause low platelet counts and anemia. Notify your doctor immediately if you notice unexplained bruising, bleeding, or unusual fatigue.
• Pregnancy should be avoided during treatment. If pregnancy is suspected, inform your doctor immediately.
• Trastuzumab deruxtecan may affect fetal development. Women should use effective contraception during treatment and for at least 7 months after the last dose; men should use effective contraception for at least 4 months after the last dose.
• Breastfeeding should be avoided during treatment and for at least 7 months after the last dose.
• Trastuzumab deruxtecan may impair male fertility. Male patients may discuss fertility preservation with their physician before starting treatment.

Possible Side Effects

• Allergic reactions: During infusion, if you develop itching, rash, swelling of the face or hands, swelling or tingling of the lips or throat, chest tightness, difficulty breathing, dizziness, or palpitations, notify healthcare personnel immediately.
• Nausea and vomiting: Your doctor will prescribe antiemetic medications to help prevent nausea and vomiting. If symptoms do not improve despite antiemetic use, inform your doctor.
• Bone marrow suppression: Includes low white blood cells, low platelet counts, and anemia, which may cause fatigue, decreased immunity, and increased bleeding risk. Monitor for abnormal bruising or pinpoint bleeding and notify your doctor of any abnormalities.
• Decreased cardiac function (reduced LVEF): Trastuzumab deruxtecan may affect the heart’s pumping ability, leading to symptoms such as fatigue, shortness of breath, cough, palpitations, leg swelling, or sudden weight gain. Seek medical attention if new or worsening symptoms occur.
• Pneumonitis / Interstitial lung disease: This medication may cause lung inflammation of varying severity, presenting as shortness of breath, difficulty breathing, cough, or exertional dyspnea; in severe cases, it may be life-threatening. Seek medical attention immediately if you develop unexplained fever or new/worsening respiratory symptoms.
• Other common side effects: Hair loss, fatigue, diarrhea, constipation, abdominal pain, loss of appetite, oral mucositis, joint pain, headache, and abnormal liver function tests.

Dietary Considerations

• Inform your doctor if you are taking any over-the-counter medications, herbal products, or vitamin supplements.
• Avoid raw or undercooked foods, as well as expired or spoiled foods, during treatment to reduce the risk of infection due to lowered immunity.
• If you have special dietary needs or questions, you may schedule a nutrition consultation for personalized advice from a dietitian.