Trastuzumab

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Contents 1 Indications 2 Dosage 3 Monitor 4 Adverse-effects 5 Mechanism-of-action 6 Notes 7 More General Terms 8 References

Indications

• HER2 overexpressing breast cancer [6] (used in addition to adjuvant chemotherapy)

Dosage

• 8 mg/kg IV infusion over 90 minutes (1st dose)
• subsequent doses 6 mg/kg, every 3 weeks for 1 year [3]
• may be given for 9 weeks rather than 1 year [4]

Monitor

• cardiac function during & after treatment [7]

Adverse-effects

• infusion reaction
• cardiotoxicity*, congestive heart failure (1%) [2]

• * cardiotoxicity may be diminished if given before anthracycline

Mechanism-of-action

• monoclonal antibody against erbB2 ( her2/neu) receptor tyrosine kinase
• reduces risk of breast cancer recurrence, 2nd primary cancer & mortality [3]

Notes

• Manufacturer: Genentech Inc

More General Terms

• monoclonal antibody
• antineoplastic agent (chemotherapeutic agent)

References

1. Herceptin (Trastuzumab): Questions and Answers [1]
2. url>http://www.fda.gov/medwatch/safety/2005/safety05.htm#Herceptin</url>
3. Piccart-Gebhart MJ et al, Trastuzumab after adjuvant chemotherapy in HER2-positive breast cancer N Engl J Med 2005 Oct 20;352:1659-72 PMID: [2]
   - Romond EH, Perez EA, Bryant J, Suman VJ, Geyer CE Jr, Davidson NE, Tan-Chiu E, Martino S, Paik S, Kaufman PA, Swain SM, Pisansky TM, Fehrenbacher L, Kutteh LA, Vogel VG, Visscher DW, Yothers G, Jenkins RB, Brown AM, Dakhil SR, Mamounas EP, Lingle WL, Klein PM, Ingle JN, Wolmark N. Trastuzumab plus adjuvant chemotherapy for operable HER2-positive breast cancer. N Engl J Med. 2005 Oct 20;353(16):1673-84. PMID: [3]
   - Piccart-Gebhart MJ, Procter M, Leyland-Jones B, Goldhirsch A, Untch M, Smith I, Gianni L, Baselga J, Bell R, Jackisch C, Cameron D, Dowsett M, Barrios CH, Steger G, Huang CS, Andersson M, Inbar M, Lichinitser M, Lang I, Nitz U, Iwata H, Thomssen C, Lohrisch C, Suter TM, Ruschoff J, Suto T, Greatorex V, Ward C, Straehle C, McFadden E, Dolci MS, Gelber RD; Herceptin Adjuvant (HERA) Trial Study Team. Trastuzumab after adjuvant chemotherapy in HER2-positive breast cancer. N Engl J Med. 2005 Oct 20;353(16):1659-72. PMID: [4]
   - Hortobagyi GN. Trastuzumab in the treatment of breast cancer. N Engl J Med. 2005 Oct 20;353(16):1734-6. No abstract available. PMID: [5]
4. Joensuu H, Kellokumpu-Lehtinen PL, Bono P, Alanko T, Kataja V, Asola R, Utriainen T, Kokko R, Hemminki A, Tarkkanen M, Turpeenniemi-Hujanen T, Jyrkkio S, Flander M, Helle L, Ingalsuo S, Johansson K, Jaaskelainen AS, Pajunen M, Rauhala M, Kaleva-Kerola J, Salminen T, Leinonen M, Elomaa I, Isola J; FinHer Study Investigators. Adjuvant docetaxel or vinorelbine with or without trastuzumab for breast cancer. N Engl J Med. 2006 Feb 23;354(8):809-20. PMID: [6]
5. Guarneri V et al, Long-term cardiac tolerability of trastuzumab in metastatic breast cancer. The M.D. Andersion Cancer Center experience. J Clin Oncol 2006, 24:4107 PMID: [7]
6. Smith I et al, 2-year follow-up of trastuzumab after adjuvant chemotherapy in HER2-positive breast cancer: A randomized controlled trial. Lancet 2007, 369:29 PMID: [8]
7. Medical Knowledge Self Assessment Program (MKSAP) 15, American College of Physicians, Philadelphia 2009

trastuzumab (Herceptin)