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항목
ADCCurated CoreFDAstaleApproved
trastuzumab deruxtecan (Enhertu, T-DXd, DS-8201, TDxd)
Daiichi Sankyo / AstraZeneca·HER2
243 trials
Overview
Program
Enhertu (fam-trastuzumab deruxtecan-nxki)
Overview
Company
Daiichi Sankyo / AstraZeneca
Overview
Modality
ADC
Overview
Target
HER2
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 label
Overview
Phase
APPROVED
Overview
Status
APPROVED
Overview
Content status
Curated Core
Overview
Data Confidence
Editorial scope · Curated Core
Overview
Development Signal
Development Signal · Established
Overview
Approval status
FDA approved
Positioning
Key differentiator
High DAR (~8), bystander effect, HER2-low activity
Positioning
Known limitation
HER2 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
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 expression (IHC/ISH per indication); higher systemic exposure associated with greater ILD incidence (FDA label §12.2).
Toxicology
Species
Cynomolgus monkey, NHP, Rat, Hamster
Toxicology
Animal (cat.)
NHP
Toxicology
Major finding
ILD-like lung findings at high exposure
Toxicology
CRS
Minimal
Toxicology
NOAEL
10 mg/kg
Clinical
Safety signal
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
APPROVED
Clinical
Trial activity
No active/completed counts
Clinical
Trial ref
NCT04784715
Preclinical
Animal (cat.)
Human, Mouse, In vitro