Management of neutropenia with ENHERTU1

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

  • In patients with metastatic breast cancer and other solid tumors treated with ENHERTU 5.4 mg/kg, a decrease in neutrophil count was reported in 65% of patients. Sixteen percent had Grade 3 or 4 events. Median time to first onset was 22 days (range: 2 to 664). Febrile neutropenia was reported in 1.1% 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. See below for dose modifications

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 NCI-CTCAE v.5.0.

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 1 hour

Toxicity grades are in accordance with NCI-CTCAE v.5.0.

Review management information for these other potential treatment risks:

Get ENHERTU Resources for You and Your Practice

An ENHERTU resource guide summarizing the efficacy and safety, dosing and administration, and recommendations for managing adverse reactions
Ready to learn more about ENHERTU?
ANC, absolute neutrophil count; NCI-CTCAE, National Cancer Institute–Common Terminology Criteria for Adverse Events.