Difference between revisions of "Trastuzumab (Herceptin)"

Revision as of 17:46, 1 December 2017

General information

Class/mechanism: HER2/neu receptor antagonist, humanized IgG1 kappa monoclonal antibody. Trastuzumab binds to the extracellular domain of HER2/erbB2 (human epidermal growth factor receptor 2), which is overexpressed in certain malignancies. Trastuzumab helps to mediate antibody-dependent cellular cytotoxicity (ADCC) preferentially against cells that overexpress HER2.^[1]^[2]^[3]
Route: IV
Extravasation: neutral

For conciseness and simplicity, HemOnc.org currently will focus on treatment regimens and not list information such as: renal/hepatic dose adjustments, metabolism (including CYP450), excretion, monitoring parameters (although this will be considered for checklists), or manufacturer. Instead, for the most current information, please refer to your preferred pharmacopeias such as Micromedex, Lexicomp, UpToDate (courtesy of Lexicomp), or the prescribing information.^[1]

Diseases for which it is used

Patient drug information

History of changes in FDA indication

9/25/1998: Initial FDA approval as a single agent for treatment of patients with metastatic breast cancer whose tumors overexpress the HER2 protein and who have received one or more chemotherapy regimens for their metastatic disease.
8/28/2002: Label revised: trastuzumab in combination with paclitaxel is indicated for treatment of patients with metastatic breast cancer whose tumors overexpress the HER2 protein and who have not received chemotherapy for their metastatic disease.
11/16/2006: Label revised: trastuzumab as part of a treatment regimen containing doxorubicin, cyclophosphamide, and paclitaxel is indicated for the adjuvant treatment of patients with HER2-overexpressing, node-positive breast cancer.
1/18/2008: Labeling simplified: indicated for the treatment of HER2 overexpressing breast cancer.
10/20/2010: Label expanded to include the treatment of HER2-overexpressing metastatic gastric or gastroesophageal junction adenocarcinoma.

Also known as

Brand names: Biceltis, CANMab, Herceptin, Herclon, Hertraz

References

[insert-1] 1.0 ^1.1 Trastuzumab (Herceptin) package insert

[2] Trastuzumab (Herceptin) package insert (locally hosted backup)

[3] Herceptin manufacturer's website

[4] Trastuzumab (Herceptin) manufacturer's patient website

[5] Trastuzumab (Herceptin) patient drug information (Chemocare)

[6] Trastuzumab (Herceptin) patient drug information (UpToDate)

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[2]

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 ==History of changes in FDA indication==
-*9/25/1998: Initial FDA approval as a single agent for treatment of patients with metastatic [[Breast cancer | breast cancer]] whose tumors overexpress the HER2 protein and who have received one or more chemotherapy regimens for their metastatic disease.
+*9/25/1998: Initial FDA approval as a single agent for treatment of patients with metastatic [[Breast_cancer,_HER-2_positive|breast cancer whose tumors overexpress the HER2 protein]] and who have received one or more chemotherapy regimens for their metastatic disease.
-*8/28/2002: Label revised: trastuzumab in combination with [[Paclitaxel (Taxol) | paclitaxel]] is indicated for treatment of patients with metastatic [[Breast cancer | breast cancer]] whose tumors overexpress the HER2 protein and who have not received chemotherapy for their metastatic disease.
+*8/28/2002: Label revised: trastuzumab in combination with [[Paclitaxel (Taxol) | paclitaxel]] is indicated for treatment of patients with metastatic [[Breast_cancer,_HER-2_positive| breast cancer whose tumors overexpress the HER2 protein]] and who have not received chemotherapy for their metastatic disease.
-*11/16/2006: Label revised: trastuzumab as part of a treatment regimen containing [[Doxorubicin (Adriamycin) | doxorubicin]], [[Cyclophosphamide (Cytoxan) | cyclophosphamide]], and [[Paclitaxel (Taxol) | paclitaxel]] is indicated for the adjuvant treatment of patients with HER2-overexpressing, node-positive [[Breast cancer | breast cancer]].
+*11/16/2006: Label revised: trastuzumab as part of a treatment regimen containing [[Doxorubicin (Adriamycin) | doxorubicin]], [[Cyclophosphamide (Cytoxan) | cyclophosphamide]], and [[Paclitaxel (Taxol) | paclitaxel]] is indicated for the adjuvant treatment of patients with [[Breast_cancer,_HER-2_positive|HER2-overexpressing, node-positive breast cancer]].
-*1/18/2008: Labeling simplified: indicated for the treatment of HER2 overexpressing [[Breast cancer | breast cancer]].
+*1/18/2008: Labeling simplified: indicated for the treatment of [[Breast_cancer,_HER-2_positive|HER2 overexpressing breast cancer]].
 *10/20/2010: Label expanded to include the treatment of HER2-overexpressing metastatic [[Gastric cancer | gastric]] or [[Esophageal cancer | gastroesophageal junction]] adenocarcinoma.