You have cancer.
Those are three words no one ever wants to hear, especially if you learn that your cancer has metastasized, or spread to other parts of your body. A cancer diagnosis can turn your world upside down — physically, emotionally, and spiritually. That’s why having a care team to guide, support, and stand by you makes all the difference.
Samantha Wagner, an oncology-certified nurse at Sanford Health in Bismarck, North Dakota, helps hundreds of patients with metastatic solid cancer navigate the storm of a cancer diagnosis and partners with them throughout their treatment journeys, ensuring they receive both the medical and emotional care they need.
“A patient’s care team does more than administer medication, take vitals, and make sure you’re comfortable during treatment,” says Wagner. “We also make sure patients understand the complexities of their disease and treatment plans, provide a safe space to express understandable fears and anxieties, and help connect the dots. My main priority is letting my patients and their families know they’re not alone.”
As a new cancer patient, when you’re hit with a wave of medical terms that sound like a foreign language, it’s no surprise if nothing sticks the first time. “Patients and families often receive so much information at once, and it can be easy to forget,” Wagner says. That’s why she takes extra care to explain that not all metastatic solid cancers are the same, and neither are someone’s treatment options.
Thanks to ongoing research, more treatments now target specific biomarkers — like genes, proteins, or cell receptors that cause cancer to grow. Since some metastatic solid cancers spread faster than others, knowing which biomarkers are involved can be key to finding the appropriate therapy.
What is HER2 positive (IHC 3+) metastatic solid cancer?
One well-known cancer biomarker is called HER2, short for human epidermal growth factor receptor 2, which is a protein that regulates cell development. In some cancers, the body makes too much of it, which can cause cells to grow and form tumors.
Doctors use a testing method called immunohistochemistry (IHC) to measure how much HER2 is present on the surface of cells. The results are given a score from 0 to 3+; if a tumor scores a 3+, it’s considered HER2 positive (IHC 3+), meaning it has high levels of HER2 present on the surface of cells.
While HER2 is often associated with breast cancer, targeted therapies for HER2 have also been used to treat other cancers like gastric, non-small cell lung, and colorectal. HER2 overexpression can be present in other types of solid tumors as well, including in biliary tract, bladder, cervical, endometrial, ovarian and pancreatic cancers.
Solid tumors make up about 90 percent of adult cancers, and metastatic disease causes the majority of death in those cases. Knowing a patient’s HER2 status can help inform future clinical decision making for doctors.
“I've talked with some of my patients about HER2 overexpression in metastatic solid tumors beyond breast and openly share that I recently learned about research on HER2 as an actionable biomarker in multiple metastatic solid tumors,” Wagner says. “These data* may still not be widely known among clinicians and patients, so it’s important to get the word out so doctors can test patients with metastatic solid tumors for HER2 overexpression.”
Why HER2 biomarker testing matters
HER2 positive (IHC 3+) metastatic solid tumors tend to grow and spread rapidly, which is why early testing for HER2 is so important. There are different tests physicians can use to determine levels of HER2 in the body. However, an IHC test will specifically identify overexpression of HER2.
“It’s important to me that the patients I care for understand the significance of HER2 testing because it can help inform treatment options,” says Wagner. "Understanding specific biomarkers is crucial because it can help guide targeted treatment decisions.”
ENHERTU (fam-trastuzumab deruxtecan-nxki): A treatment option for HER2+ (IHC3+) metastatic solid tumors
ENHERTU is a targeted treatment approved for certain patients with HER2 positive (IHC 3+) metastatic cancer. This prescription medicine is approved to treat adults who have solid tumors that are HER2 positive (IHC 3+) and that cannot be removed by surgery or have spread to other parts of your body (metastatic), and who have received a prior treatment and who have no other satisfactory treatment options. Your healthcare provider will perform a test to make sure ENHERTU is right for you.
ENHERTU was FDA-approved for this use based on clinical studies that measured how many patients responded and how long they responded. ENHERTU is still being studied to confirm these results. It is not known if ENHERTU is safe and effective in children.
ENHERTU can cause serious side effects. Some serious or life-threatening side effects may affect your lungs, heart, or white blood cell count, affecting your ability to fight infection.. Additional possible side effects of ENHERTU can be found in the Important Safety Information below.
ENHERTU was studied in three clinical trials involving various HER2 positive (IHC 3+) metastatic solid tumors. These studies only evaluated ENHERTU, and there were no comparisons of results to other treatment options.
Wagner advocates for eligible patients to talk to their doctors about treatment with ENHERTU. “HER2 positive cancer beyond breast tumors once seemed unfamiliar, but today a treatment exists for certain patients across many HER2 positive (IHC 3+) metastatic solid tumors,” Wagner says. “I help patients understand that cancer care evolves frequently and targeted treatments, like ENHERTU, may offer additional options for certain patients.”
The power of self-advocacy and support
A strong support system is important after a metastatic cancer diagnosis — not just for a patient’s emotional well-being, but for making informed decisions. “Advocating for yourself is crucial, as no one can do it better than you,” says Wagner. “But it is equally important to lean on the nurses within your care team who can help families navigate through these challenging times.”
Wagner sees firsthand how much of a difference compassionate care can make. “The truth is, I’m so inspired by the strength and resilience of the patients I care for, that it drives me to be the best nurse I can be every day,” she says.
Her advice to patients? Trust the process, stay curious, and don’t be afraid to ask questions. “Stay informed with legitimate resources and embrace new ideas and advances that can potentially lead to improved outcomes and greater peace of mind,” says Wagner.
If you or someone you care about is facing metastatic cancer, know that you’re not alone. Healthcare professionals like Wagner are a resource to help you understand your diagnosis, explore biomarker testing, and navigate your next steps with clarity and support.
*Additional data here and here.
The information provided on this site isn’t intended as medical advice, and shouldn’t replace professional medical treatment. Consult your doctor with any serious health concerns.
Important Safety Information
What is the most important information I should know about ENHERTU?
ENHERTU can cause serious side effects, including:
- Lung problems that may be severe, life-threatening or that may lead to death. If you develop lung problems your healthcare provider may treat you with corticosteroid medicines. Tell your healthcare provider right away if you get any of the following signs and symptoms:
- cough
- trouble breathing or shortness of breath
- fever
- other new or worsening breathing symptoms (such as chest tightness, wheezing)
- Low white blood cell count (neutropenia). Low white blood cell counts are common with ENHERTU and can sometimes be severe. Your healthcare provider will check your white blood cell counts before starting ENHERTU and before starting each dose. Tell your healthcare provider right away if you develop any signs or symptoms of an infection or have fever or chills during treatment with ENHERTU.
- Heart problems that may affect your heart's ability to pump blood. Your healthcare provider will check your heart function before starting treatment with ENHERTU and during treatment if needed. Tell your healthcare provider right away if you get any of the following signs and symptoms:
- new or worsening shortness of breath
- coughing
- feeling tired
- swelling of your ankles or legs
- irregular heartbeat
- sudden weight gain
- dizziness or feeling light-headed
- loss of consciousness
Your healthcare provider will check you for these side effects during your treatment with ENHERTU. Your healthcare provider may reduce your dose, delay treatment or completely stop treatment with ENHERTU if you have severe side effects.
- Harm to your unborn baby. Tell your healthcare provider right away if you become pregnant or think you might be pregnant during treatment with ENHERTU.
- If you are able to become pregnant, your healthcare provider should do a pregnancy test before you start treatment with ENHERTU.
- Females who are able to become pregnant should use effective birth control (contraception) during treatment with ENHERTU and for 7 months after the last dose.
- Males who have female partners that are able to become pregnant should use effective birth control (contraception) during treatment with ENHERTU and for 4 months after the last dose.
Before you receive ENHERTU, tell your healthcare provider about all of your medical conditions, including if you:
- have lung or breathing problems
- have signs or symptoms of an infection
- have or have had any heart problems
- are breastfeeding or plan to breastfeed. It is not known if ENHERTU passes into your breast milk. Do not breastfeed during treatment with ENHERTU and for 7 months after the last dose.
Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements.
How will I receive ENHERTU?
- You will receive ENHERTU into your vein through an intravenous (IV) line by your healthcare provider.
- ENHERTU is given 1 time every three weeks (21-day treatment cycle).
- Your healthcare provider will decide how many treatments you need.
- Your healthcare provider will give you medicines before your infusion to help prevent nausea and vomiting.
- Your healthcare provider may slow down or temporarily stop your infusion of ENHERTU if you have an infusion-related reaction, or permanently stop ENHERTU if you have severe infusion reactions.
- If you miss a planned dose of ENHERTU, call your healthcare provider right away to schedule an appointment. Do not wait until the next planned treatment cycle.
What are the possible side effects of ENHERTU?
ENHERTU can cause serious side effects. See "What is the most important information I should know about ENHERTU?"
The most common side effects of ENHERTU, when used alone at the 5.4 mg/kg dose in people with HER2-positive solid tumors and other solid tumors include:
- low white blood cell counts
- nausea
- low red blood cell counts
- feeling tired
- low platelet counts
- increased liver function tests
- vomiting
- hair loss
- constipation
- low levels of blood potassium
- decreased appetite
- diarrhea
- muscle or bone pain
ENHERTU may cause fertility problems in males, which may affect the ability to father children. Talk to your healthcare provider if you have concerns about fertility.
These are not all of the possible side effects of ENHERTU. Call your doctor for medical advice about side effects. You may report side effects to Daiichi Sankyo at 1-877-437-7763 or to FDA at 1-800-FDA-1088.
What is ENHERTU?
ENHERTU alone is a prescription medicine used to treat adults with solid tumors that are HER2-positive (IHC 3+) and that cannot be removed by surgery or have spread to other parts of your body (metastatic), and who have received a prior treatment and have no other satisfactory treatment options. Your healthcare provider will perform a test to make sure ENHERTU is right for you.
- ENHERTU was FDA approved for this use based on clinical studies that measured how many patients responded and how long they responded. ENHERTU is still being studied to confirm these results.
It is not known if ENHERTU is safe and effective in children.
Please see full Prescribing Information, including Boxed WARNINGS, and Medication Guide.
ENHERTU® is a registered trademark of Daiichi Sankyo Company, Limited.
©2026 Daiichi Sankyo, Inc. and AstraZeneca.
PP-US-ENTA-0351 08/26
