Neutropenia

Management of neutropenia with ENHERTU1

Severe neutropenia, including febrile neutropenia, can occur in patients treated with ENHERTU. In DESTINY-Gastric01, of the 125 patients with locally advanced or metastatic HER2-positive gastric or GEJ adenocarcinoma treated with ENHERTU 6.4 mg/kg, a decrease in neutrophil count was reported in 72% of patients. 51% had Grade 3 or 4 decreased neutrophil count. Median time to first onset of decreased neutrophil count was 16 days (range: 4 to 187). Febrile neutropenia was reported in 4.8% 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, ENHERTU may require dose interruption or 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).
ANC, absolute neutrophil count.

Dose modifications for febrile neutropenia1

Severity Treatment Modification
Absolute neutrophil count of less than 1.0 x 109/L and temperature is 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).

Review information for these other potential treatment risks:

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