Trastuzumab deruxtecan (T-DXd)
Deterministic view of the source YAML entity. Clinical authority remains with the cited source IDs and reviewer sign-off state.
| ID | DRUG-TRASTUZUMAB-DERUXTECAN |
|---|---|
| Type | Drug |
| Aliases | EnhertuТрастузумаб дерукстекан |
| Status | pending_clinical_signoff |
| Diseases | DIS-BREAST DIS-CRC DIS-ESOPHAGEAL DIS-GASTRIC DIS-NSCLC |
| Sources | SRC-ESMO-BREAST-METASTATIC-2024 SRC-NCCN-BREAST-2025 |
Drug Facts
| Class | HER2-targeted antibody-drug conjugate (deruxtecan / topo-I inhibitor payload) |
|---|---|
| Mechanism | Trastuzumab linked to deruxtecan (DXd, exatecan derivative) via cleavable linker. High drug-to-antibody ratio (~8:1) and bystander effect — kills neighboring HER2-low cells. Active in HER2-positive AND HER2-low (IHC 1+ or 2+ FISH-) and HER2-ultralow. |
| Typical dosing | 5.4 mg/kg IV q3 weeks until progression or unacceptable toxicity. |
| Ukraine registered | True |
| NSZU reimbursed | True |
| Ukraine last verified | 2026-04-27 |
Notes
DESTINY-Breast03: T-DXd superior to T-DM1 in 2L HER2+ metastatic. DESTINY-Breast04: HER2-low metastatic. DESTINY-Breast06: HER2-low first-line. ILD risk requires baseline CT + monitoring; pulmonology consult on any new respiratory symptoms.
Used By
Regimens
REG-T-DXD-NSCLC- Trastuzumab deruxtecan (DESTINY-Lung01/02) — HER2-mutant NSCLC 2L+REG-TDXD-GASTRIC- Trastuzumab deruxtecan (T-DXd) — 2L+ HER2+ gastric (DESTINY-Gastric01)REG-TDXD-METASTATIC- T-DXd monotherapy (HER2+ metastatic 2L+, also HER2-low metastatic)REG-TRASTUZUMAB-DERUXTECAN-CRC- Trastuzumab-deruxtecan monotherapy (DESTINY-CRC01, HER2+ mCRC)