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FDA Approves T-DXd With Pertuzumab for First-Line HER2+ Breast Cancer Treatment

FDA Approves enhertu Combination for First-Line HER2-Positive Breast cancer TreatmentTable of ContentsFDA Approves enhertu Combination for First-Line HER2-Positive Breast cancer TreatmentThe Phase 3 DESTINY-Breast09 Clinical TrialFDA Approves new Treatment Combination for HER2-Positive Breast cancerFDA Approves Fam-Trastuzumab Deruxtecan-Nxki and…

FDA Approves T-DXd With Pertuzumab for First-Line HER2+ Breast Cancer Treatment

FDA Approves enhertu Combination for First-Line HER2-Positive Breast cancer Treatment

Table of Contents

The FDA approved fam-trastuzumab deruxtecan-nxki (T-DXd, Enhertu; Daiichi Sankyo, Inc.) in combination with pertuzumab (Perjeta; Genentech) for the first-line treatment of adults with unresectable or metastatic HER2-positive (HER2+; IHC 3+ or ISH+) breast cancer as determined by an FDA-approved test.

Simultaneously, the FDA also approved the PATHWAY anti-HER-2/neu (4B5) Rabbit Monoclonal Primary Antibody and HER2 Dual ISH DNA Probe Cocktail as companion diagnostic devices for selecting HER2-positive (HER2 IHC3+ or ISH+) breast cancer patients for treatment with T-DXd in combination with pertuzumab.1

!X-ray of breast cancer — Image credit: Sebastian Kaulitzki | stock.adobe.com
Image credit: Sebastian Kaulitzki | stock.adobe.com

The Phase 3 DESTINY-Breast09 Clinical Trial

The approval is supported by positive findings from the randomized,3-arm,multicenter,global phase 3 clinical trial,DESTINY-Breast09 (NCT04784715),which compared T-DXd with or without pertuzumab to taxane,trastuzumab (Herceptin; Genentech),and pertuzumab (THP).

The trial consisted of 1157 adults with HER2+ advanced or metastatic breast cancer who had not received prior chemotherapy or HER2-targeted therapy or had received neoadjuvant or adjuvant HER2-targeted therapy more than 6 months prior to the diagnosis of advanced or metastatic disease.2

FDA Approves new Treatment Combination for HER2-Positive Breast cancer

The Food and Drug Governance (FDA) recently approved a new combination therapy for patients with unresectable or metastatic HER2-positive breast cancer. The treatment combines fam-trastuzumab deruxtecan-nxki (enhertu) with pertuzumab. This approval offers a new option for individuals whose cancer has progressed after prior anti-HER2 therapies.

Previously, patients with HER2-positive breast cancer who had received prior anti-HER2 treatments faced limited options.The DESTINY-Breast09 clinical trial (NCT04784715) demonstrated significant benefits with trastuzumab deruxtecan (T-DXd), with or without pertuzumab, compared to standard taxane, trastuzumab, and pertuzumab regimens. The trial, updated as of November 12, 2025, showed improved progression-free survival and overall survival in patients treated with the new combination.

Fam-trastuzumab deruxtecan-nxki is a HER2-directed antibody drug conjugate. It delivers a potent chemotherapy agent directly to cancer cells, minimizing exposure to healthy tissues. Pertuzumab is another HER2-targeted therapy that enhances the effectiveness of trastuzumab.

This approval represents a significant advancement in the treatment of HER2-positive breast cancer, offering renewed hope for patients facing this challenging diagnosis.

FDA Approves Fam-Trastuzumab Deruxtecan-Nxki and Pertuzumab for Unresectable or Metastatic HER2-Positive Breast cancer
2. Trastuzumab Deruxtecan (T-DXd) With or Without Pertuzumab Versus Taxane, Trastuzumab and Pertuzumab in HER2-positive Metastatic breast Cancer (DESTINY-Breast09). ClinicalTrials.gov identifier: NCT04784715. Updated November 12,2025. Accessed December 15, 2025.
About the author: Dr Natalie Singh - Health Editor

Board‑certified internal‑medicine physician and MPH. Natalie authored peer‑reviewed studies on infectious disease and served as medical editor. “Dr. Natalie Singh delivers evidence‑based health news, medical breakthroughs, and expert wellness guidance.”