Trastuzumab deruxtecan
Trastuzumab deruxtecan (T-DXd) is an antibody–drug conjugate directed against human EGFR 2 (Human epidermal growth factor receptor 2 (HER2)), the protein encoded by Human epidermal growth factor receptor 2 (HER2).
Trastuzumab deruxtecan (T-DXd) is an antibody–drug conjugate directed against human EGFR 2 (Human epidermal growth factor receptor 2 (HER2)), the protein encoded by Human epidermal growth factor receptor 2 (HER2). It combines a trastuzumab-derived monoclonal antibody with deruxtecan, a topoisomerase I inhibitor, through a cleavable linker. After binding Human epidermal growth factor receptor 2 (HER2) on tumor cells, the conjugate is internalized and releases its cytotoxic payload, thereby causing DNA damage and cell death. Its activity is therefore dependent on both Human epidermal growth factor receptor 2 (HER2) recognition and delivery of the intracellular chemotherapy payload.
T-DXd is used as a Human epidermal growth factor receptor 2 (HER2)-directed treatment across several solid Tumors, including breast cancer, gastric and esophageal Cancer, and selected Human epidermal growth factor receptor 2 (HER2)-altered lung Cancers. Its clinical and biological significance is influenced by variation in Human epidermal growth factor receptor 2 (HER2) protein expression, gene amplification, and intratumoral heterogeneity. HER2-low or Human epidermal growth factor receptor 2 (HER2)-negative subclones may affect treatment response and resistance, while alternative treatment strategies include Human epidermal growth factor receptor 2 (HER2) tyrosine-kinase inhibitors such as zongertinib. As an antibody–drug conjugate, T-DXd differs mechanistically from ado-trastuzumab emtansine and from immune checkpoint inhibitors such as nivolumab, atezolizumab, and durvalumab.
Where the papers sit
9 papers from the last 6 months study trastuzumab deruxtecan directly · updated from PubMed 1 Nov 2026
Study type 1 clinical trial · 4 observational · 2 human data · 2 preclinical
Themes 3 themes
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Metastatic HER2 Breast Cancer
Metastatic HER2-low and HER2-positive breast cancer care is moving toward more individualized treatment selection and toxicity management. Baseline albumin, imaging, histologic grade and clinical stage are being explored as predictors of severe adverse events or chemoresistance. Radiotherapy with trastuzumab deruxtecan and rechallenge after progression remain clinically relevant but require careful patient selection. S100-RAGE signaling offers a mechanistic explanation for intrinsic resistance and a possible therapeutic target.
5 papers · 55.6%
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HER2-Targeted Lung Cancer Therapy
HER2-altered lung cancer treatment is shifting toward matching antibody-drug conjugates and tyrosine-kinase inhibitors to the underlying alteration. Trastuzumab deruxtecan is being evaluated against conventional therapy in advanced NSCLC and as blockade after or before agents such as zongertinib. EGFR ectodomain mutations and ERBB2 signaling highlight receptor cross-talk as a route to cetuximab resistance. Sequencing strategies and the durability of responses remain open clinical questions.
3 papers · 33.3%
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Residual Disease in Triple-Negative Breast Cancer
Residual disease after neoadjuvant chemotherapy remains the central risk marker in triple-negative breast cancer. Molecular evaluation is being used to refine prognosis beyond pathological response alone. Recurring signals include immune biology, interferon activity and MHC class I expression. The work supports better selection of patients for intensified adjuvant strategies, although the most predictive markers remain unsettled.
1 papers · 11.1%
Papers
The 9 papers from the last 6 months that study trastuzumab deruxtecan directly, newest first, by theme and by study type. Study types come from PubMed publication types and MeSH headings.
By theme
Metastatic HER2 Breast Cancer (5)
- Baseline Serum Albumin Is Associated With Severe Adverse Events During Trastuzumab Deruxtecan Treatment in Metastatic Breast Cancer. Anticancer research · 27 Oct 2026 PMID 42946412
- Predicting Chemoresistance in HER2-low Breast Cancer: Histologic Grade, MRI Non-mass Enhancement, and Clinical T Stage. Anticancer research · 1 Oct 2026 PMID 42823184
- Beyond safety: rethinking concomitant radiotherapy and trastuzumab deruxtecan in metastatic breast cancer - from feasibility to precision practice. Breast (Edinburgh, Scotland) · 18 Aug 2026 PMID 42612559
- Trastuzumab deruxtecan rechallenge in HER2-positive metastatic breast cancer: EN-SEMBLE. Breast (Edinburgh, Scotland) · 10 Aug 2026 PMID 42575050
- Targetable S100-RAGE Signaling Mediates Intrinsic Trastuzumab Deruxtecan Resistance in Metastatic Breast Cancer. Clinical cancer research : an official journal of the American Association for Cancer Research · 17 Jul 2026 PMID 42467226
HER2-Targeted Lung Cancer Therapy (3)
- First-line treatment outcomes in HER2-altered advanced NSCLC: a real-world multi-center study comparing trastuzumab deruxtecan with conventional therapies and analysis by HER2/EGFR co-alteration status. BMC cancer · 13 Oct 2026 PMID 42864628
- Rechallenge with zongertinib after trastuzumab deruxtecan in HER2-mutant lung cancer: A case report. Lung cancer (Amsterdam, Netherlands) · 13 Jun 2026 PMID 42287786
- EGFR S442 ectodomain mutation confers cetuximab resistance that can be overcome by ERBB2 blockade with trastuzumab-deruxtecan. Cancer letters · 23 May 2026 PMID 42176792
Residual Disease in Triple-Negative Breast Cancer (1)
- Molecular evaluation of residual disease following neoadjuvant chemotherapy in triple-negative breast cancer CALGB 40603 (Alliance). The Journal of clinical investigation · 4 Aug 2026 PMID 42550611
By study type
Clinical trials (1)
- Molecular evaluation of residual disease following neoadjuvant chemotherapy in triple-negative breast cancer CALGB 40603 (Alliance). The Journal of clinical investigation · 4 Aug 2026 PMID 42550611
Observational studies and case reports (4)
- Baseline Serum Albumin Is Associated With Severe Adverse Events During Trastuzumab Deruxtecan Treatment in Metastatic Breast Cancer. Anticancer research · 27 Oct 2026 PMID 42946412
- Predicting Chemoresistance in HER2-low Breast Cancer: Histologic Grade, MRI Non-mass Enhancement, and Clinical T Stage. Anticancer research · 1 Oct 2026 PMID 42823184
- Trastuzumab deruxtecan rechallenge in HER2-positive metastatic breast cancer: EN-SEMBLE. Breast (Edinburgh, Scotland) · 10 Aug 2026 PMID 42575050
- Rechallenge with zongertinib after trastuzumab deruxtecan in HER2-mutant lung cancer: A case report. Lung cancer (Amsterdam, Netherlands) · 13 Jun 2026 PMID 42287786
Human data, design not indexed (2)
- First-line treatment outcomes in HER2-altered advanced NSCLC: a real-world multi-center study comparing trastuzumab deruxtecan with conventional therapies and analysis by HER2/EGFR co-alteration status. BMC cancer · 13 Oct 2026 PMID 42864628
- Beyond safety: rethinking concomitant radiotherapy and trastuzumab deruxtecan in metastatic breast cancer - from feasibility to precision practice. Breast (Edinburgh, Scotland) · 18 Aug 2026 PMID 42612559
Preclinical: animal, cell and lab studies (2)
- Targetable S100-RAGE Signaling Mediates Intrinsic Trastuzumab Deruxtecan Resistance in Metastatic Breast Cancer. Clinical cancer research : an official journal of the American Association for Cancer Research · 17 Jul 2026 PMID 42467226
- EGFR S442 ectodomain mutation confers cetuximab resistance that can be overcome by ERBB2 blockade with trastuzumab-deruxtecan. Cancer letters · 23 May 2026 PMID 42176792
Written from 9 PubMed abstracts, each one listed by PMID above. Published: 2026-08-20. Drafted by language models from published abstracts; not medical advice.