Summary
NHS England will make trastuzumab deruxtecan, sold as Enhertu, available to around 1,000 women with HER2-low advanced or metastatic breast cancer after their disease progresses following treatment.
NHS England will make trastuzumab deruxtecan, sold as Enhertu, available to around 1,000 women with HER2-low advanced or metastatic breast cancer whose disease has progressed after treatment.
The decision follows an updated recommendation from the National Institute for Health and Care Excellence (NICE) and negotiations over the drug’s cost. Enhertu is made by Daiichi Sankyo and AstraZeneca.
Who the NHS decision covers
The treatment is intended for women with an incurable form of breast cancer classified as HER2-low. The term describes tumours that produce some HER2 protein, but at a level below the conventional threshold used to classify a cancer as HER2-positive. This distinction matters because the amount of HER2 on cancer cells can influence whether a HER2-targeted medicine is considered suitable.
The NHS announcement applies to a defined group: patients in England with advanced or metastatic disease, after their cancer has progressed following previous treatment. It is not a general change in access to Enhertu for every person with breast cancer.
Trastuzumab deruxtecan is an antibody-drug conjugate. Its antibody component binds to HER2 on cancer cells and is designed to deliver a chemotherapy payload to those cells. The treatment’s use in this setting reflects the presence of lower levels of HER2 than in traditionally HER2-positive disease.
Why the recommendation changed
NICE had previously not recommended the treatment, a decision that campaigners criticised. The updated recommendation came after changes to NHS rules for assessing whether medicines provide value for money. The BMJ report links those changes to the UK-US drug pricing deal and says the subsequent cost negotiations enabled NHS England to offer the medicine to the eligible group.
For patients, the practical change is access through the English NHS to a treatment that had previously been outside the recommended route for this form of breast cancer. The decision is a health-service and medicines-access development rather than a report of a new clinical trial.
What the announcement means
The reported availability of Enhertu is significant because HER2-low breast cancer is treated as a distinct therapeutic subgroup. Around 1,000 women in England are expected to gain access under the updated recommendation, according to the report.
The decision also shows how the price and value assessment of an established medicine can affect whether it becomes available through a national health system. Its scope remains tied to the NICE recommendation and the eligibility group described above: HER2-low advanced or metastatic breast cancer that has progressed after treatment.