From the Guidelines
Enhertu (Trastuzumab deruxtecan) is not primarily considered an immunosuppressive medication, but it can cause myelosuppression, leading to neutropenia in approximately 13.6% of patients, with a 2.2% risk of fatal interstitial lung disease/pneumonitis, as reported in a phase II study 1.
Mechanism of Action
Enhertu is an antibody-drug conjugate that targets HER2-positive cancer cells, delivering a cytotoxic component that kills these cells. Its primary mechanism of action is not immune suppression, but rather the selective targeting of cancer cells.
Immune-Related Side Effects
While Enhertu can affect the immune system, its side effects are more related to the targeted delivery of cytotoxic agents to cancer cells. The most significant immune-related side effect is the risk of interstitial lung disease (ILD) or pneumonitis, which can be fatal in some cases.
Monitoring and Precautions
Patients receiving Enhertu should have regular monitoring for signs of ILD or pneumonitis, as well as blood count monitoring to detect any significant drops in white blood cells. Healthcare providers may recommend precautions against infection if neutropenia develops, and active surveillance is crucial for the safe utilization of this compound in clinical practice 1.
Conclusion on Immunosuppressive Effects
In summary, while Enhertu is not an immunosuppressive medication by design, it can have immune-related side effects, particularly the risk of ILD/pneumonitis and myelosuppression. These risks should be carefully managed and monitored in clinical practice to minimize the potential for adverse outcomes.
From the Research
Immunosuppressive Effect of Enhertu (Trastuzumab deruxtecan)
- The provided studies do not directly discuss the immunosuppressive effect of Enhertu (Trastuzumab deruxtecan) 2, 3, 4, 5, 6.
- However, it is mentioned that Trastuzumab deruxtecan can cause interstitial lung disease (ILD)/pneumonitis, which requires careful monitoring 2, 3, 6.
- Common treatment-related adverse events included haematological and gastrointestinal disorders, which may indicate some level of immunosuppression 2, 3.
- Neutropenia, a condition characterized by an abnormally low number of neutrophils, is also mentioned as a common adverse event, which can be a sign of immunosuppression 5, 6.
- There is no direct evidence in the provided studies to fully understand the immunosuppressive effect of Enhertu (Trastuzumab deruxtecan), and further research may be needed to determine its impact on the immune system.