Neutropenia

Management of neutropenia with ENHERTU1

    Severe neutropenia, including febrile neutropenia, can occur in patients treated with ENHERTU.

  • Of the 234 patients with unresectable or metastatic HER2-positive breast cancer who received ENHERTU 5.4 mg/kg, a decrease in neutrophil count was reported in 62% of patients and 16% had Grade 3 or 4 decrease in neutrophil count. Febrile neutropenia was reported in 1.7% of patients
  • Monitor complete blood counts prior to initiation of ENHERTU and prior to each dose, and as clinically indicated
  • Based on the severity of neutropenia, manage through treatment interruption or dose reduction

Dose modifications for neutropenia1

Severity Treatment Modification
Grade 3
(ANC less than 1.0 to 0.5 x 109/L)
  • Interrupt ENHERTU until resolved to Grade 2 or less, then maintain dose
Grade 4
(ANC less than 0.5 x 109/L)

Toxicity grades are in accordance with the National Cancer Institute—Common Terminology Criteria for Adverse Events Version 4.03 (NCI-CTCAE v.4.03).

Dose modifications for febrile neutropenia1

Severity Treatment Modification
Absolute neutrophil count of less than 1.0 x 109/L and temperature greater than 38.3°C or a sustained temperature of ≥38°C for more than one hour
Toxicity grades are in accordance with the National Cancer Institute—Common Terminology Criteria for Adverse Events Version 4.03 (NCI-CTCAE v.4.03).

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ANC, absolute neutrophil count; HER2, human epidermal growth factor receptor 2.