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항목
AntibodyCurated CoreFDAstaleApproved
trastuzumab (Herceptin, Ogivri, Herzuma)
Roche / Genentech·HER2
1100 trials
ADCCurated CoreFDAstaleApproved
trastuzumab deruxtecan (Enhertu, T-DXd, DS-8201, TDxd)
Daiichi Sankyo / AstraZeneca·HER2
243 trials
Overview
Program
Herceptin (trastuzumab)Enhertu (fam-trastuzumab deruxtecan-nxki)
Overview
Company
Roche / GenentechDaiichi Sankyo / AstraZeneca
Overview
Modality
ANTIBODYADC
Overview
Target
HER2HER2
Overview
Indication
HER2+ breast cancer, HER2+ gastric/GEJ adenocarcinomaHER2-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 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
novel bifunctional chelator (2E-C-NETA) for applications in 177 Lu-based TRTHigh DAR (~8), bystander effect, HER2-low activity
Positioning
Known limitation
resistance to trastuzumab-based targeted therapy and limited intratumoral antibody penetration continue to restrict clinical outcomesHER2 antigen loss/downregulation, payload efflux, and dose-limiting ILD/pneumonitis leading to discontinuation.
Positioning
Development positioning
—Indication- and regimen-specific; includes 1L + pertuzumab in HER2-positive metastatic breast cancer
Technology
Payload
—DXd (topo-I inhibitor)
Technology
Linker
—Cleavable tetrapeptide
MoA
Mechanism
Trastuzumab binds domain IV of HER2, inhibiting ligand-independent HER2 signaling, mediating ADCC via Fcγ receptors, and inducing internalization/degradation of HER2.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.
MoA
Biomarker
HER2 IHC 3+ or ISH amplified (ASCO/CAP guidelines).HER2 expression (IHC/ISH per indication); higher systemic exposure associated with greater ILD incidence (FDA label §12.2).
Toxicology
Species
RatCynomolgus monkey, NHP, Rat, Hamster
Toxicology
Animal (cat.)
—NHP
Toxicology
Major finding
Cardiotoxicity (LVEF decline, CHF risk especially with anthracyclines); infusion reactions; myelosuppression in combos.ILD-like lung findings at high exposure
Toxicology
CRS
N/AMinimal
Toxicology
NOAEL
—10 mg/kg
Clinical
Safety signal
Cardiotoxicity (LVEF decline, CHF risk especially with anthracyclines); infusion reactions; myelosuppression in combos.ILD-like lung findings at high exposure
Clinical
Selected reported efficacy
—ORR 87%
Clinical
Reported ORR
—87% vs 81% (THP)
Clinical
Reported PFS
—40.7 months vs 26.9 months (THP)
Clinical
Reported OS
—Immature at the reported PFS analysis
Clinical
Result source
—FDA label 2026, Table 28 — DESTINY-Breast09 (NCT04784715)
Clinical
Program phase
APPROVEDAPPROVED
Clinical
Trial activity
No active/completed countsNo active/completed counts
Clinical
Trial ref
—NCT04784715
Preclinical
Animal (cat.)
Mouse, In vitroHuman, Mouse, In vitro