Trastuzumab (Herceptin)

INTRODUCTION:
  • A recombinant humanized monoclonal antibody against human epidermal growth receptor 2 protein (HER2)
  • Trastuzumab Shows better response in combination with paclitaxel
INDICATIONS:
  • Approved to be used alone or with other drugs to treat:
  1. Adenocarcinoma of stomach or gastro esophageal junction.
  2. HER2 positive(HER2+) disease that has metastasized (spread to other parts of the body) in patients who have not already been treated for metastatic cancer.
  3. Breast cancer that is HER2+.
  4. HER2 overexpressed by many adenocarcinomas, particularly breast adenocarcinomas
  5. Overexpression of the HER2 protein, amplification of the HER2 gene, or both, occur in approximately 15-25% of breast cancers associated with aggressive behaviour in the tumour
  6. For women with breast cancer who have an overexpression of HER2
  7. Adjuvant therapy (before/after/in combination) with established other chemotherapeutic agents (eg anthracyclines and taxanes), surgery and radiation treatment.
  8. Has survival benefit when given with chemotherapy to patients with early, operable, and metastatic breast cancer that has HER2 overexpression or amplification
MODE OF ACTION:
  • After binding to HER2 on the tumor cell surface, trastuzumab induces an antibody-dependent cell-mediated cytotoxicity against tumor cells that overexpress HER2
  • Trastuzumab mediates ADCC: Once bound to the Fc domain of trastuzumab, the NK cells release substances that perforate the tumour cell membrane and promote cell death
ADVERSE EFFECT:
  • Diarrhea
  • Constipation
  • Heartburn
  • Loss of appetite
  • Back, bone, joint, or muscle pain
  • Difficulty falling asleep or staying asleep
  • Numbness, burning, or tingling in the arms, hands, feet, or legs
  • Changes in the appearance of nails
  • Cardiomyopathy
  • Sore throat, fever, chills, difficulty urinating, pain when urinating, and other signs of infection
  • Nosebleeds and other unusual bruising or bleeding
  • Excessive tiredness
  • Pale skin
Exam Question
  • Trastuzumab has specific activity in a subset of female breast cancers
  • Trastuzumab Shows better response in combination with paclitaxel
  • Trastuzumab is Used in metastatic breast cancer
  • Trastuzumab is a monoclonal antibody produced by injecting her-2 antigen
  • Trastuzumab causes dilated cardiomyopathy.

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