[13] Trastuzumab deruxtecan was approved for medical use in the United States in December 2019,[12] in Japan in March 2020,[14] in the European Union in January 2021,[8][10] and in Australia in October 2021.

[12] Efficacy was evaluated in a multicenter, open-label, randomized trial (DESTINY-Gastric01, NCT03329690) in participants with HER2-positive locally advanced or metastatic gastric or GEJ adenocarcinoma who had progressed on at least two prior regimens, including trastuzumab, a fluoropyrimidine- and a platinum-containing chemotherapy.

[13] A total of 188 participants were randomized (2:1) to receive trastuzumab deruxtecan 6.4 mg/kg intravenously every three weeks or physician's choice of either irinotecan or paclitaxel monotherapy.

[13] Efficacy was based on DESTINY-Breast03 (NCT03529110), a multicenter, open-label, randomized trial that enrolled 524 participants with HER2-positive, unresectable, and/or metastatic breast cancer who received prior trastuzumab and taxane therapy for metastatic disease or developed disease recurrence during or within six months of completing neoadjuvant or adjuvant therapy.

[15] In September 2023, the UK's National Institute for Heath and Care Excellence (NICE) published guidance that it would not recommend Trastuzumab deruxtecan, to be used for treatment HER2 LOW breast cancer by the UK's National Heath Service (NHS), citing the cost of the drug being too high in comparison to its benefits.

Enhertu was however approved by The Scottish Medicines Consortium for use by NHS Scotland in December 2023[19] Trastuzumab deruxetecan remains funded for patients with HER2 positive advanced breast cancers.

[8][10] In January 2021, the FDA granted accelerated approval to trastuzumab deruxtecan for the treatment of adults with locally advanced or metastatic HER2-positive gastric or gastroesophageal (GEJ) adenocarcinoma who have received a prior trastuzumab-based regimen.

[13][24] In October 2021, the Australian Therapeutic Goods Administration approved trastuzumab deruxtecan for provisional registration indicated for the treatment of adults with unresectable or metastatic HER2-positive breast cancer who have received two or more prior anti HER2-based regimens.