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항목
ADCCurated CoreFDAstaleApproved
trastuzumab deruxtecan (Enhertu, T-DXd, DS-8201, TDxd)
Daiichi Sankyo / AstraZeneca·HER2
243 trials
ADCCurated CoreFDAstaleApproved
datopotamab deruxtecan-dlnk (Datroway, DS-1062, Dato-DXd)
Daiichi Sankyo / AstraZeneca·TROP2
50 trials
Overview
Program
Enhertu (fam-trastuzumab deruxtecan-nxki)Datroway (datopotamab deruxtecan-dlnk)
Overview
Company
Daiichi Sankyo / AstraZenecaDaiichi Sankyo / AstraZeneca
Overview
Modality
ADCADC
Overview
Target
HER2TROP2
Overview
Indication
HER2-positive breast cancer (including regimen-specific first-line and early-stage indications); HER2-low/ultralow breast cancer, HER2-positive gastric cancer, HER2-mutant NSCLC and HER2-positive solid tumors: consult the current US labelHR-positive/HER2-negative breast cancer after specified prior therapies; EGFR-mutated NSCLC after specified prior therapies; first-line TNBC unsuitable for PD-1/PD-L1 therapy. Consult current US label.
Overview
Phase
APPROVEDAPPROVED
Overview
Status
APPROVEDAPPROVED
Overview
Content status
Curated CoreCurated Core
Overview
Data Confidence
Editorial scope · Curated CoreEditorial scope · Curated Core
Overview
Development Signal
Development Signal · EstablishedDevelopment Signal · Established
Overview
Approval status
FDA approvedFDA approved
Positioning
Key differentiator
High DAR (~8), bystander effect, HER2-low activitySame DXd chemistry that made Enhertu work, aimed at TROP2 — high plasma stability with a short-half-life payload to limit systemic exposure.
Positioning
Known limitation
HER2 antigen loss/downregulation, payload efflux, and dose-limiting ILD/pneumonitis leading to discontinuation.TROP2 loss, SLFN11 status, and topoisomerase I pathway adaptation.
Positioning
Development positioning
Indication- and regimen-specific; includes 1L + pertuzumab in HER2-positive metastatic breast cancerIndication-specific; includes 1L TNBC unsuitable for PD-1/PD-L1 therapy
Technology
Payload
DXd (topo-I inhibitor)DXd (exatecan derivative, topoisomerase I inhibitor)
Technology
Linker
Cleavable tetrapeptideTetrapeptide-based cleavable maleimide linker, DAR ~4
Technology
DAR
—DAR 4
MoA
Mechanism
Fam-trastuzumab deruxtecan is a HER2-directed antibody-drug conjugate: humanized anti-HER2 IgG1 linked via a cleavable tetrapeptide linker to DXd, a membrane-permeable topoisomerase I inhibitor. After binding HER2 on tumor cells, the conjugate is internalized; lysosomal proteases cleave the linker and release DXd, causing DNA damage and apoptosis. Released DXd can exert a bystander effect in neighboring cells.Anti-TROP2 antibody delivers DXd intracellularly after lysosomal linker cleavage; topoisomerase I inhibition drives DNA damage, with membrane-permeable payload producing a bystander effect.
MoA
Biomarker
HER2 expression (IHC/ISH per indication); higher systemic exposure associated with greater ILD incidence (FDA label §12.2).TROP2 expression is not a required companion diagnostic; quantitative continuous scoring (QCS) is investigational.
Toxicology
Species
Cynomolgus monkey, NHP, Rat, HamsterRat, Hamster
Toxicology
Animal (cat.)
NHP—
Toxicology
Major finding
ILD-like lung findings at high exposureStomatitis, dry eye and keratitis, nausea, and alopecia. Interstitial lung disease is a class warning for DXd conjugates and requires prompt steroid intervention.
Toxicology
CRS
MinimalN/A
Toxicology
NOAEL
10 mg/kg—
Clinical
Safety signal
ILD-like lung findings at high exposureStomatitis, dry eye and keratitis, nausea, and alopecia. Interstitial lung disease is a class warning for DXd conjugates and requires prompt steroid intervention.
Clinical
Selected reported efficacy
ORR 87%ORR 64%
Clinical
Reported ORR
87% vs 81% (THP)64% vs 30% (chemotherapy)
Clinical
Reported PFS
40.7 months vs 26.9 months (THP)10.8 months vs 5.6 months (chemotherapy)
Clinical
Reported OS
Immature at the reported PFS analysis23.7 months vs 18.7 months (chemotherapy)
Clinical
Result source
FDA label 2026, Table 28 — DESTINY-Breast09 (NCT04784715)FDA approval report 2026-05-22 — TROPION-Breast02 (NCT05374512)
Clinical
Program phase
APPROVEDAPPROVED
Clinical
Trial activity
No active/completed countsNo active/completed counts
Clinical
Trial ref
NCT04784715NCT05374512
Preclinical
Animal (cat.)
Human, Mouse, In vitroMouse, In vitro