Daiichi, AZ's first Enhertu DTC campaign kicks off during Thursday Night Football

As Enhertu’s reach continues to spread into additional forms of breast cancer, Daiichi Sankyo and AstraZeneca are ramping up awareness of the drug among its expanded patient pool.

To that end, the companies on Thursday debuted the first direct-to-consumer campaign for Enhertu. The “Not Today” campaign rollout began with the premiere of a 90-second commercial during the Thursday Night Football broadcast on Amazon’s Prime Video.

On top of being Enhertu’s first foray into DTC marketing, the campaign represents “the first DTC that we’ve developed at Daiichi Sankyo for any of our oncology products," Dan Switzer, head of Daiichi’s U.S. oncology business, told Fierce Pharma Marketing in an interview.

Enhertu, a HER2-targeted antibody-drug conjugate, was first approved by the FDA in 2019 as a third-line treatment for inoperable or metastatic HER2-positive breast cancer. Since then, it’s earned additional approvals as a second-line treatment and for HER2-low cases of breast cancer.

Throughout that time, Switzer said, all outreach has been directed toward healthcare providers.

“But with the expansion of our clinical program and, in particular, a couple of key studies that we’ve released data [from] recently, the utilization for Enhertu is going to get greater and greater,” he said, likely referring to the drug’s recent positive showing both as an earlier-line treatment for HER2-low breast cancer and in HER2-ultralow cases. "About nine out of 10 patients living with metastatic breast cancer will be eligible for Enhertu at some point in their treatment journey," Switzer said.

“So, we thought this was exactly the right time to start to tailor some of our communication directly to patients, so that patients and their caregivers know that Enhertu might be able to benefit them [and] might even be a life-changing medicine for them,” he added.

Though Enhertu has in recent years earned FDA approvals outside of breast cancer—including green lights in HER2-positive stomach cancer and HER2-mutant lung cancer, and, just this spring, a tumor-agnostic nod—the drug’s first campaign focuses on breast cancer “because it is the biggest set of indications for Enhertu,” according to Switzer.

He added, “Because we’re broadening the HER2-positive and the HER2-low and -ultralow landscape, we want to use it as an educational opportunity for the patients we think we can impact most immediately.”

The TV ad features a handful of women going about their daily lives. They start by taking turns confessing to being a “cheater,” a “thief” or a “liar,” before one clarifies, “but not like you think.”

Trading off lines, they continue: “I have metastatic breast cancer. And I pretend that I’m fine, but I’m tricking my cancer. I’m yanking back more moments, memories with Enhertu.”

As a voice-over picks up the thread, giving details of Enhertu’s indications, side effects and clinical results—including the claim that “Enhertu helped people live longer than other medicines”—the camera continues to follow each of the women.

The scenes, all of which are shot in black and white, document both highs and lows in each of their lives, from joyful moments with their partners, caregivers, friends and children to more somber solo moments in which each woman appears lost in thought.

The group closes out the commercial by saying, “Sure, metastatic breast cancer will try to take it all—but not today.”

Daiichi Sankyo/AstraZeneca Enhertu DTC campaign Not Today
A still from the "Not Today" commercial. (Daiichi Sankyo/AstraZeneca)

The muted aesthetic and mix of high and low moments were a deliberate choice for the promo, Switzer said, and came out of conversations with real patients.

“Something that a lot of patients have told us is that when they see some of the ads that are currently available, especially for metastatic breast cancer, they show those happy moments, they show people on the beach, they show time with loved ones—which is all really important,” he said. “This ad resonated with them because we are showing those happy moments, but also, you’ll see there’s times where patients are clearly being very thoughtful, sad, even concerned. And the backdrop of the black and white is actually to bring that out.”

Overall, the ad’s imagery is meant to paint a more realistic portrayal of life with metastatic breast cancer. That ties into the dual-pronged goal of the overall campaign, which was created not only to inform patients about the availability of Enhertu but also to help those around them better understand the daily realities of the disease, according to Switzer.

“Some of the patients that we spoke to, once we showed them the ad, they told us that when they see it, they feel heard, they feel emboldened, and it gives them permission to acknowledge that sometimes they’re not OK, where often they feel some pressure to act like everything is OK,” he said.

Daiichi and AZ’s aim of improving the broader public’s understanding of life with breast cancer was also the impetus for the choice to debut the ad during Thursday Night Football, which last year reached an average of nearly 12 million viewers per week.

“So many of us know somebody living with breast cancer or metastatic breast cancer. We think it’s a great place to start to communicate about Enhertu,” Switzer said. “We’re hoping that this ad can actually be a vehicle for the breast cancer patients who we spoke to, whose insights really helped shape our campaign, for them to message to the broader community at large. And if we can serve that purpose, we’ll be thrilled.”

The commercial and broader campaign will run through a variety of channels, including streaming services like Amazon, Hulu, BET+ and Paramount+, social media platforms like Instagram, Facebook, X (formerly Twitter) and Reddit, in print via People magazine and on screens in oncologists’ offices.

Daiichi Sankyo/AstraZeneca Enhertu DTC campaign Not Today
The "Not Today" campaign's print ad will run in People magazine (Daiichi Sankyo/AstraZeneca)

The campaign in its current iteration is set to run through the end of March. From there, Switzer said, “we’re going to use the information that we gather from feedback and all the metrics to evolve it, to improve it and, likely, to expand it.”

The drug’s makers will be measuring success through a variety of metrics both quantitative and qualitative—the most important of which, per Switzer, will be “what we hear back from patients who have seen the ad.”

“We’re going to want to know, of course, that it resonated with them. We’re going to want to know that they connect with it,” he said. “And if we hear back through market research, through focus groups that patients are seeing it, patients are connecting with it and, as importantly, those who surround them are getting a better appreciation for what it’s like to live with the disease—that’s how we’ll know we’ve been successful.”