When you or someone close to you is diagnosed with breast cancer, you may have heard doctors use terms like ' HER2-Positive ' or 'HER2-low'. These are actually names used to describe the types of cancer cells. There are now new, advanced medications to treat these types of cancers. One such special medication is Enhertu. Today, we'll talk about this in a simple, easy-to-understand way.
What kind of medicine is Enhertu? How does it work?
Simply put, Enhertu is a targeted therapy . To be precise, it is a type of drug called an `Antibody-Drug Conjugate (ADC).` While the name may sound a bit complicated, the way it works is quite amazing.
Think of this medicine as a smart missile. It's made up of three parts:
1. Target-finding part (Antibody): This part finds a special protein called `HER2` on the surface of cancer cells and attaches to it. The job of this part is to selectively identify and protect only cancer cells, without harming healthy cells.
2. Payload: This is the drug that kills cancer cells. To be precise, this is a powerful type of chemotherapy.
3. The part that connects these two (Linker): The two parts mentioned above are connected together by this linker.
So, when you give this drug, the antibody part of it goes straight to the cancer cells that have the `HER2` protein. Then, the drug is absorbed into the cell. Once inside the cell, the chemo part is released and destroys the cancer cell. As the cancer cells die, the cancer cells shrink and stop growing.
The biggest advantage of this method is that the drug directly targets only cancer cells, so the damage to healthy cells is greatly reduced.
How is Enhertu given?
Enhertu is a medicine given intravenously. This means it is given into the body as a saline solution (IV infusion). This treatment will be given to you by a healthcare professional in a hospital, clinic, or specialized treatment center.
- Duration: This treatment is usually given once every 3 weeks .
- Dosage: The amount of medicine you need is determined by your body weight. Your doctor will calculate it exactly and prescribe it.
- Duration: If your cancer is responding well to this medication, your doctor will likely advise you to continue this treatment for as long as possible. However, if you experience certain side effects, you may need to change the dose, temporarily stop treatment, or stop it altogether. Your doctor will discuss all of these with you and make decisions.
How effective is the Enhertu drug really?
Two clinical trials investigating the effectiveness of the Enhertu drug have yielded very good results.
1. Comparison of Enhertu and Kadcyla (DESTINY-Breast03 trial)
In this trial, Enhertu was compared with Kadcyla (ado-trastuzumab emtansine), another drug that targets ``HER2.'' The results are shown in the table below.
| Comparison point | Enhertu treatment | Kadcyla treatment |
|---|---|---|
| Progression-Free Survival (This is the time it takes for half of patients to get their cancer back or not spread) | 28.8 months | 6.8 months |
| Percentage of patients who did not spread the disease after 12 months | 75.2% | 33.9% |
| Percentage of patients who did not spread the disease after 24 months | 53.7% | 26.4% |
2. Comparison of Enhertu and chemotherapy (DESTINY-Breast04 trial)
This trial compared Enhertu with standard chemotherapy.
| Comparison point | Enhertu treatment | Chemotherapy treatment |
|---|---|---|
| Progression-Free Survival | 9.9 months | 5.1 months |
| Overall Survival (This is the time that half of the patients who received treatment survived) | 23.4 months | 16.8 months |
This data shows that Enhertu is a much more effective treatment than some of the current treatments .
How do I monitor my recovery?
Enhertu starts working as soon as you receive your first dose. Your doctor will do various tests to see how your body is responding to the medicine.
- Scans: A scan is usually done about 6 weeks after starting treatment to check the progress of the cancer. This may be done earlier or later.
- Blood tests: Regular blood tests are done to check your white blood cell, neutrophil, and platelet counts. This will help determine if you can safely continue taking the medication. If you experience side effects, such as coughing, you may also have other special tests done to look for them.
Side effects and how to manage them?
Side effects are common with cancer treatments. This is also true for Enhertu. The most important thing is to tell your doctor about any side effects you experience. He or she will determine whether they are serious and tell you what to do about them.
To prevent common side effects like vomiting and nausea, your doctor may prescribe other medications to take before giving you the medicine. It is very important to follow those instructions exactly.
In addition, you can also do simple things like these to help control nausea, vomiting, and diarrhea:
- Eat bland foods with less oil and chili.
- Instead of three large meals, eat several small meals a day.
Depending on the severity of some side effects, your doctor may decide to reduce the dose of your medication, temporarily stop treatment, or stop it altogether. Don't worry about it. It's all for your safety.
Are there any special warnings to be aware of?
Yes. Enhertu has a very serious black box warning . This is the highest warning issued by the FDA (US Food and Drug Administration).
1. Harm to the unborn child: You should completely avoid getting pregnant while taking this medicine. This can seriously harm an unborn baby. If you or your partner are planning to become pregnant, be sure to tell your doctor . Your doctor will advise you on the appropriate birth control methods to use during treatment.
2. Lung damage: This medicine can cause a serious lung condition called `Interstitial Lung Disease (ILD).` Therefore, your doctor will monitor you for this throughout the course of treatment. If you experience symptoms such as cough and difficulty breathing, inform your doctor immediately.
Because of these factors, it is very important to maintain constant contact with the doctor and follow his instructions exactly.
Take-Home Message
- Enhertu is an advanced drug that targets the HER2 protein in breast cancer and kills only cancer cells.
- This is a treatment given through a vein (IV) every 3 weeks.
- Clinical trials have proven that this medicine is more effective than other treatments currently used.
- Side effects such as nausea and vomiting may occur during treatment, and there are ways to manage them. Inform your doctor immediately about any discomfort.
- Taking this medicine during pregnancy can cause serious harm to the unborn baby, and there is a risk of serious side effects that affect the lungs. Talk to your doctor about this openly.
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