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**Trastuzumab deruxtecan + hyaluronidase** is a hypothetical or non-standard combination drug that suggests the pairing of two distinct agents: - **Trastuzumab deruxtecan** (fam-trastuzumab deruxtecan-nxki, brand name Enhertu) is an antibody-drug conjugate composed of trastuzumab (a monoclonal antibody targeting HER2) linked to the topoisomerase I inhibitor deruxtecan, indicated for HER2-expressing breast cancers and others. Its mechanism involves targeted delivery of cytotoxic chemotherapy to HER2-overexpressing tumor cells resulting in cell death[2][6]. - **Hyaluronidase** (often in the form of recombinant human hyaluronidase such as hyaluronidase-oysk or hyaluronidase-zzxf) is an enzyme that depolymerizes hyaluronan to increase tissue permeability and facilitate absorption and dispersion of co-administered drugs, notably monoclonal antibodies given subcutaneously[1][3][5]. Currently, there are approved combinations of trastuzumab + hyaluronidase (Herceptin Hylecta, generic name trastuzumab and hyaluronidase-oysk), and pertuzumab + trastuzumab + hyaluronidase-zzxf (Phesgo), but there is no approved or clinically described product known as trastuzumab deruxtecan + hyaluronidase. Trastuzumab deruxtecan is administered intravenously without hyaluronidase[2][6].
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