Trastuzumab

Uses	HER2-positive breast cancer, Metastatic gastric cancer
Therapy	Anti-Neoplastic
Side Effects	Chills, fever, flu-like symptoms, nausea

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Molecule Description

Trastuzumab is an anti-cancer medicine used by cancer specialists to treat HER2 positive of breast and metastatic stomach (gastric) cancer. It targets a protein called HER2, which is present in unusually large amounts on some cancer cells. By binding to HER2, Trastuzumab stops these cancer cells from growing. Trastuzumab is used in several treatment settings, including early breast cancer with high HER2 levels and metastatic breast cancer. It may be given alone or alongside other cancer treatments such as chemotherapy or hormone therapy, depending on the type and stage of the cancer. It is given in hospital as an injection or infusion by a doctor or nurse. Treatment needs monitoring of heart function, because Trastuzumab can affect how well the heart pumps. Tell your doctor about any heart condition, previous anthracycline chemotherapy, breathing problems or hepatitis infection before treatment starts. Trastuzumab can harm an unborn baby. Effective contraception is needed during treatment and for the period your doctor advises afterwards, and breastfeeding should be avoided over the same period.

Uses

Trastuzumab is used by cancer specialists in the treatment of breast cancers, including HER2-positive early breast cancer and metastatic breast cancer. It is also used in the management of metastatic stomach cancer.

Contraindications

When should one not use Trastuzumab

If you are allergic to Trastuzumab or any of the ingredients of the product you are given

Side effects

Common side effects of this drug are:

Chills
Fever
Flu-like symptoms
Nausea
Vomiting
Headache
Dizziness
Difficulty breathing (shortness of breath)
High or low blood pressure
Palpitations or irregular heartbeat
Swelling of the face, lips, or other areas (angioedema)
Rash
Tiredness (fatigue)
Reduced heart pumping function, which your doctor will monitor

Precautions and Warnings

Pregnancy

Trastuzumab should be avoided during pregnancy as it can harm the unborn baby. Effective contraception should be used during treatment and for the period your doctor advises after treatment ends.

Breast Feeding

Trastuzumab can pass into breast milk and could harm a breastfeeding baby. Avoid breastfeeding during treatment and for the period your doctor advises after the last dose.

Driving

Treatment with Trastuzumab may affect your ability to drive or use machinery. If you have dizziness, sleepiness, chills or fever during treatment, do not drive or use machinery until these symptoms settle.

Alcohol

No interaction between alcohol and Trastuzumab is known. Discuss alcohol with your doctor in the context of your overall treatment.

Other General Warnings

Talk to your doctor if

You have a history of heart problems or reduced heart function.
You have previously received anthracycline-based chemotherapy.
You develop shortness of breath, unusual tiredness, or swelling, which may be signs of heart problems.
You have a lung condition that causes symptoms or extensive cancer involvement of the lungs, particularly if you have difficulty breathing at rest.
You develop difficulty breathing, low blood pressure, rash, or swelling of the face or lips during or after the infusion.
You develop symptoms during the infusion or hours to days afterwards, as serious infusion reactions may sometimes be delayed.
You develop a new or worsening cough or difficulty breathing.
You are pregnant or planning a pregnancy. Trastuzumab can harm an unborn baby, and effective contraception is recommended during treatment and for 7 months after the last dose.
You are breastfeeding. Breastfeeding is not recommended during treatment and for 7 months after the last dose.

Mode of Action

How Does It Work?

Trastuzumab is a targeted cancer therapy that acts on cancer cells producing too much of the HER2 protein. By attaching to HER2, it blocks the signals that make these cells grow and divide, and it helps the immune system recognise and destroy them. Because it acts mainly on HER2-positive cells, its effect on healthy cells is limited.

Interactions

Interactions with other medicines

Tell your doctor about all medicines, supplements and herbal products you take or plan to take.
Tell your doctor if you are receiving or have previously received anthracycline chemotherapy, as combining trastuzumab with anthracyclines can increase the risk of heart problems. Your doctor will monitor your heart function before and during treatment.

Interactions with food items

No specific food interactions have been established with Trastuzumab. It is given into a vein, so food does not affect how it works.

Dosage

Overdose

Trastuzumab is given by a doctor or nurse, so an overdose is very unlikely. If you develop symptoms straight after an infusion, seek medical help immediately.

Missed a Dose

Your doctor or nurse schedules and gives each dose, so a missed dose is unlikely. If you think a dose has been missed, tell your treating team immediately.

Frequently Asked Questions (FAQs)

HER2 is a protein on the surface of cells that tells them to grow. Some breast cancers make far too much of it, which makes the cancer grow faster. These are called HER2-positive cancers, and they are the ones Trastuzumab is used for. A laboratory test on the tumour confirms this before treatment starts.

Trastuzumab can reduce how strongly the heart pumps, particularly in people who have had anthracycline chemotherapy or who already have heart disease. Your doctor checks heart function before and during treatment so that any change is picked up early.

Some people develop chills, fever, shaking, breathlessness or a drop in blood pressure during or shortly after an infusion. These reactions are common with the first dose and are managed by the team giving the treatment. Tell them straight away if you feel unwell during an infusion.

No. It can harm an unborn baby. Effective contraception is needed during treatment and for the period your doctor advises afterwards.