Targeted Therapy Enhertu’s Cross Tumor Approval: Physician-Scientist Gerold Meinhardt From Drugmaker Daiichi Sankyo On The Huge Implications & The Next Round of HER2 Research

How the Drug Enhertu is Improving Cancer Treatment

• Enhertu, a new FDA-approved drug, treats multiple cancer types by targeting HER2, a protein that accelerates cancer growth.
• As a ‘tumor-agnostic’ treatment, Enhertu effectively targets cancers based on the common characteristic of HER2 protein overexpression, regardless of what type of cancer it is.
• By delivering treatment directly to cancer cells, Enhertu minimizes damage to surrounding healthy tissue, leading to fewer severe side effects and more effective treatment.
• Ongoing research suggests that Enhertu may prove to be effective in some instances where there is minimal HER2 expression, potentially expanding its use even further.

Enhertu , a new FDA-approved drug,  treats multiple cancer types by targeting HER2, a protein that accelerates cancer growth. It offers new hope to patients diagnosed with a variety of advanced cancers such as breast, gastric, lung, colorectal, and several gynecological cancers including cervical, ovarian and endometrial. Dr. Gerold Meinhardt , a medical oncologist and hematologist who was instrumental in the development of Enhertu for Daiichi Sankyo US , tells SurvivorNet that the drug is unique because it can be effective regardless of the type of cancer diagnosed. “This is remarkable because usually drugs are approved only for one or two or certain specific types of cancers, but not for a large number of other patients having different types of cancers. So this is something, this is a label that is given very rarely and is a testimony to the fact that Enhertu really is a targeted therapy,” he explains. Related: New Hope For Breast Cancer Warriors

Enhertu's Unique Mechanism and Wide-Ranging Efficacy

Enhertu is particularly effective against tumors that overexpress the HER2 protein —a condition seen in more aggressive cancers. This protein, when activated, leads to a faster growth and spread of cancer cells. As a type of drug known as an antibody-drug conjugate (ADC), Enhertu uniquely delivers treatment directly to cancer cells and largely avoids the surrounding healthy tissue. This precision not only helps the patient have a better quality of life due to fewer harsh side effects – it also makes the treatment more effective. “I think it's important to raise awareness that HER2 is a target not only for breast cancer, potentially gastric cancer patients, but there are many tumor types where at least in a certain percentage of patients the HER2 receptor is expressed,” he notes. Dr. Meinhardt explains that Enhertu is one of the few drugs considered to be 'tumor-agnostic' in nature. It is sometimes referred to as pan-tumor therapy because it targets cancer characteristics common across multiple tumor types. (Pan is the Greek word for "all".) If the cancer expresses a high amount of Her2 protein, regardless of where in the body it is, Enhertu is likely to offer some benefit, according to Dr. Meinhardt. "...about 37% of patients having partial or complete responses,” he says. “But in some groups of patients, especially endometrial, cervical, ovarian, we saw unprecedented high rates of response but also long stabilization of disease and long time of response," he adds, emphasizing the drug's broad potential. Dr. Meinhardt also underscores the potential shifts in treatment practices due to ongoing research. Patients confirmed to have HER2-positive cancer—through tests like Immunohistochemistry (IHC) are the ideal candidates for Enhertu, Dr. Meinhardt says, especially if other treatments have failed or their cancer has returned. IHC is a specialized lab technique used to identify specific proteins found within a patient's tissue sample. Related: The Drug Enhertu Is Now Approved Across Tumor Types — What To Ask Your Doctor

Future Directions and Ongoing Research in Enhertu's Application

Ongoing studies suggest the use of Enhertu may be expanded in the future. “...this year, another important study in breast cancer, the DESTINY trials where we are even testing what is usually called Her2-ultra low patients, some signals of efficacy from other studies have already been seen,” he elaborates. In other words, based on some preliminary evidence, even tumors with minimal HER2 expression may show some response to Enhertu. If this turns out to be the case, it could lead to new treatment protocols involving Enhertu, helping another group of patients with advanced cancer. “As any treating physician knows, it's often the combination of different anti-cancer drugs that brings the greatest benefits and we have seen unprecedented strong efficacy within HER2 in breast cancer and some other tumor types. But there is, as always, still room for improvement for even higher response rates and longer durations where patients have a response and hence the obvious question is – what is next?” Dr. Meinhardt says. Related: HER2-Low, A New Classification Of Breast Cancer, Expands The Use Of Enhertu For Metastatic Patients