- Enhertu is a targeted treatment for certain HER2-low breast cancers.
- It is available for around 1,000 women in England.
- The drug can extend survival compared with chemotherapy.
- NICE initially rejected widespread NHS use in 2024.
- The decision was reversed after a commercial agreement was reached.
Breast cancer treatment continues to evolve as researchers develop therapies aimed at specific characteristics of cancer cells. One such treatment is Enhertu, which has now become available on the NHS in England for people with a particular type of advanced breast cancer.
The treatment is intended for patients with HER2-low breast cancer that cannot be removed through surgery or has spread to other parts of the body. This is known as metastatic breast cancer. According to the latest announcement, around 1,000 women in England will be eligible for the treatment.
Enhertu had previously faced a different outcome. NICE rejected it for widespread NHS use in England in 2024 after concluding that it was "not cost effective". That decision has now been reversed following an agreement described as a "commercial solution".
So what exactly is Enhertu, who can receive it and why has its availability become significant for people living with advanced breast cancer?
What is Enhertu and who is it for?
Enhertu, also known as trastuzumab deruxtecan, is a targeted cancer treatment made by Daiichi Sankyo and AstraZeneca.
It is the first licensed targeted treatment specifically available for patients with HER2-low breast cancer that is either inoperable or has spread elsewhere in the body.
HER2 refers to a protein found on the surface of some breast cancer cells. The source article specifically refers to patients whose cancers are classified as HER2-low. This is different from HER2-positive breast cancer and represents a group of patients for whom treatment options can differ.
The NHS availability announced in September 2026 applies to eligible patients in England. The treatment has already been available in Scotland for more than two years.
How much extra time could Enhertu provide?
The main reason Enhertu has attracted attention is its effect on survival in clinical trials.
According to the reported trial results, women with breast cancer who received the drug survived for around two years on average, compared with 17.5 months among those who received chemotherapy.
The treatment can therefore provide close to seven additional months of life on average compared with chemotherapy, according to the reported figures.
It is important to understand what these figures mean. They describe results observed across groups of patients in clinical research and do not mean that every individual receiving Enhertu will live for a particular length of time. Response to cancer treatment can vary between people.
For someone living with metastatic breast cancer, however, additional time can have a deeply personal meaning. Patients quoted following the announcement described hopes ranging from seeing their children grow up to attending major milestones in their families' lives.
Paula Van Santen, who was diagnosed with metastatic breast cancer in July 2022, said the decision had given her a "new sense of hope".
"Today is a day I never thought I'd see.
"After years of waiting and hoping, there aren't enough words to express how thrilled I am to see Enhertu finally approved for use on the NHS.
"It gives me the chance of seeing my daughter graduate from university, become a grandparent for the first time and simply be a mum to my children for longer as they continue to grow."
Why was Enhertu initially rejected by NICE?
Enhertu's route to NHS availability in England has not been straightforward.
NICE initially rejected the drug for widespread use in England in 2024 because it was considered "not cost effective". The decision was later reversed after a "commercial solution" was agreed as part of a pricing agreement involving changes to NICE's methods and the UK and US.
The reversal means eligible patients in England can now access the treatment through the NHS.
Breast Cancer Now described the announcement as "a momentous day". Its chief executive Claire Rowney said the treatment would give thousands of people "the opportunity to gain precious extra time with loved ones; more ordinary days that become extraordinary because they were there".
However, the charity also highlighted the impact of the earlier decision. Ms Rowney said that "thousands of people have missed out on access to Enhertu and tragically many have died". She also called for the treatment to be made available through the NHS in Wales and Northern Ireland.
For patients such as Kathryn Hulland, who was diagnosed with metastatic breast cancer four years ago, the significance is measured not only in statistics but in time with family.
"I may still be here to support my nine-year-old daughter into high school.
"When I was first diagnosed, I was told I'd be lucky to see 12 months.
"Three years later I know how important every extra month is. It's another chance at more time with my daughter, another chance to make memories together, another month to be her mum and see her grow.
"And that's the hope this life-extending treatment now brings, it means everything."
