| Gastric Adenocarcinoma
Herceptin vs Enhertu
Side-by-side clinical, coverage, and cost comparison for gastric adenocarcinoma.Deep comparison between: Herceptin vs Enhertu with Prescriber.AI
AI compares prescribing info and payer-specific access barriers across 1,200+ formularies. Here's a preview of what prescribers are already asking.Safety signalsEnhertu has a higher rate of injection site reactions vs Herceptin based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Enhertu but not Herceptin, including UnitedHealthcare
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Category
Herceptin
Enhertu
At A Glance
IV infusion
Weekly or every 3 weeks
HER2 antagonist
IV infusion
Every 3 weeks
HER2-directed antibody-drug conjugate with topoisomerase I inhibitor
Indications
- Malignant neoplasm of breast
- Gastric Adenocarcinoma
- Adenocarcinoma of the gastroesophageal junction
- Breast Carcinoma
- Non-Small Cell Lung Carcinoma
- Gastric Adenocarcinoma
Dosing
Malignant neoplasm of breast (adjuvant) Schedule 1: 4 mg/kg loading dose over 90 min IV, then 2 mg/kg weekly over 30 min for 12 or 18 weeks, then 6 mg/kg every 3 weeks to complete 52 weeks; Schedule 2: 8 mg/kg loading dose over 90 min IV, then 6 mg/kg every 3 weeks for 52 weeks.
Malignant neoplasm of breast (metastatic) 4 mg/kg loading dose as 90-min IV infusion, then 2 mg/kg weekly as 30-min IV infusions until disease progression.
Gastric Adenocarcinoma, Adenocarcinoma of the gastroesophageal junction 8 mg/kg loading dose over 90-min IV infusion, then 6 mg/kg over 30-90 min IV every 3 weeks until disease progression, in combination with cisplatin and capecitabine or 5-fluorouracil.
Breast Carcinoma (HER2-positive, HER2-low, or HER2-ultralow) 5.4 mg/kg IV infusion every 3 weeks until disease progression or unacceptable toxicity
Breast Carcinoma (HER2-positive, first-line with pertuzumab) Cycle 1 Day 1: 5.4 mg/kg IV followed by pertuzumab 840 mg; subsequent cycles: 5.4 mg/kg IV followed by pertuzumab 420 mg every 3 weeks
Non-Small Cell Lung Carcinoma (HER2-mutant) 5.4 mg/kg IV infusion every 3 weeks until disease progression or unacceptable toxicity
Gastric Adenocarcinoma (HER2-positive) 6.4 mg/kg IV infusion every 3 weeks until disease progression or unacceptable toxicity
Contraindications
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Adverse Reactions
Most common Fever, nausea, vomiting, infusion reactions, diarrhea, infections, increased cough, headache, fatigue, dyspnea, rash, neutropenia, anemia, myalgia
Serious Cardiomyopathy, infusion reactions, embryo-fetal toxicity, pulmonary toxicity, exacerbation of chemotherapy-induced neutropenia
Postmarketing Infusion reaction, oligohydramnios, glomerulopathy, immune thrombocytopenia, tumor lysis syndrome
Most common (>=20%) Decreased white blood cell count, nausea, decreased hemoglobin, decreased neutrophil count, decreased lymphocyte count, fatigue, decreased platelet count, increased aspartate aminotransferase, increased alanine aminotransferase, increased blood alkaline phosphatase, vomiting, alopecia, decreased blood potassium, constipation, musculoskeletal pain, diarrhea, decreased appetite
Serious Interstitial lung disease, pneumonitis, pneumonia, febrile neutropenia, vomiting, nausea, hypokalemia, pulmonary embolism, sepsis
Pharmacology
Humanized IgG1 kappa monoclonal antibody (anti-HER2) that inhibits proliferation of HER2-overexpressing tumor cells and mediates antibody-dependent cellular cytotoxicity (ADCC) preferentially on HER2-overexpressing cancer cells.
Fam-trastuzumab deruxtecan-nxki is a HER2-directed antibody-drug conjugate consisting of a humanized anti-HER2 IgG1 antibody linked to a topoisomerase I inhibitor (DXd). After binding to HER2 on tumor cells, the drug undergoes internalization and lysosomal cleavage, releasing the membrane-permeable DXd that causes DNA damage and apoptotic cell death.
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Most Common Insurance
Anthem BCBS
Herceptin
- Covered on 5 commercial plans
- PA (5/12) · Step Therapy (1/12) · Qty limit (0/12)
Enhertu
- Covered on 5 commercial plans
- PA (11/12) · Step Therapy (0/12) · Qty limit (0/12)
UnitedHealthcare
Herceptin
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (0/8)
Enhertu
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (0/8)
Humana
Herceptin
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (2/3) · Qty limit (0/3)
Enhertu
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (0/3) · Qty limit (0/3)
Coverage data sourced from MMIT. Updated monthly.
Savings
No savings programs available for Herceptin.
No savings programs available for Enhertu.
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.