Cancers & treatments·Regimen libraryLater line

Trastuzumab deruxtecan 5.4 mg/kg

Checked 2026-09-09

HER2-positive metastatic breast cancer second line; HER2-low or ultralow after chemotherapy or endocrine therapy; HER2-mutant NSCLC

One cycle

every 21 days

21-day cycle, until progressionIntravenous

Components

Drug	Dose	Route	Days	Note
Trastuzumab deruxtecan ADC	5.4 mg/kg (6.4 mg/kg in gastric cancer)	IV	D1

Cycles

until progression

21-day cycle

Emetogenicity

Moderate (30-90%)

G-CSF

Not routine

Notes

Interstitial lung disease in about 10-15%: hold for any grade, permanently discontinue for grade 2 or above.
Moderately emetogenic: three-drug antiemetic prophylaxis is recommended.

Used in

HER2-positive breast cancer HR-positive / HER2-negative breast cancer Triple-negative breast cancer (TNBC)Non-small-cell lung cancer

Trials

DESTINY-Breast03 DESTINY-Breast04 DESTINY-Breast06

Products

Trastuzumab deruxtecan

Source

DESTINY-Breast04, NEJM 2022

Reference doses for a typical adult from the cited protocol or label. Doses are adjusted for renal and hepatic function, age, performance status and prior toxicity, and institutional protocols vary. Verify against the current label and your local protocol before treating. Not medical advice.