Difference between revisions of "Trastuzumab emtansine (Kadcyla)"
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Revision as of 19:57, 27 February 2020
General information
Class/mechanism: Antibody-cytotoxic agent conjugate consisting of the HER2 humanized IgG1 kappa monoclonal antibody Trastuzumab (Herceptin) linked with a small molecule microtubule inhibitor and maytansine derivative, emtansine (DM1). The humanized monoclonal antibody binds to subdomain IV of the HER2 receptor, is subjected to receptor-mediated endocytosis, and lysosomal degradation leads to the intracellular release of DM1. DM1 binds to tubulin at the rhizoxin binding site, inhibits the assembly of microtubules, and leads to cell cycle arrest and cell death via apoptosis. Similar to Trastuzumab (Herceptin), ado-trastuzumab emtansine inhibits HER2 receptor signaling, facilitates antibody-dependent cell-mediated cytotoxicity (ADCC), and inhibits shedding of the HER2 extracellular domain in HER2-overexpressing human breast cancer cells.[1][2][3][4][5][6]
Route: IV
Extravasation: irritant
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, Medscape,UpToDate (courtesy of Lexicomp), or the prescribing information.[1]
Diseases for which it is used
Patient drug information
- Ado-trastuzumab emtansine (Kadcyla) patient drug information (Chemocare)[7]
- Patient counseling information can be found in the Ado-trastuzumab emtansine (Kadcyla) package insert[1]
- Ado-trastuzumab emtansine (Kadcyla) patient drug information (UpToDate)[8]
History of changes in FDA indication
- 2/22/2013: Initial approval for patients with HER2-positive, metastatic breast cancer who previously received trastuzumab and a taxane, separately or in combination.
- 5/3/2019: Approval expanded for the adjuvant treatment of patients with HER2-positive early breast cancer (EBC) who have residual invasive disease after neoadjuvant taxane and trastuzumab-based treatment. (Indication extended to the adjuvant setting)
Also known as
- Code name: PRO132365
- Generic names: TDM1, T-DM1, trastuzumab emtansine
- Brand name: Kadcyla
References
- ↑ 1.0 1.1 1.2 Ado-trastuzumab emtansine (Kadcyla) package insert
- ↑ Ado-trastuzumab emtansine (Kadcyla) package insert (locally hosted backup)
- ↑ Kadcyla manufacturer's website
- ↑ ImmunoGen product site
- ↑ http://www.immunogen.com/img/T-DM1%20+%20pertuzumab%20at%20SABCS.pdf A Phase Ib/II Trial of Trastuzumab-DM1 (T-DM1) with Pertuzumab for Patients with HER2-Positive, Locally Advanced or Metastatic Breast Cancer: Interim Efficacy and Safety Results
- ↑ Dr. Sara Hurvitz's 2011 European Society for Medical Oncology (ESMO) Presentation
- ↑ Ado-trastuzumab emtansine (Kadcyla) patient drug information (Chemocare)
- ↑ Ado-trastuzumab emtansine (Kadcyla) patient drug information (UpToDate)