Ado-trastuzumab emtansine (Kadcyla)

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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, 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

History of changes in FDA indication

Also known as

  • Code name: PRO132365
  • Generic names: TDM1, T-DM1, trastuzumab emtansine
  • Brand name: Kadcyla


  1. 1.0 1.1 1.2 Ado-trastuzumab emtansine (Kadcyla) package insert
  2. Ado-trastuzumab emtansine (Kadcyla) package insert (locally hosted backup)
  3. Kadcyla manufacturer's website
  4. ImmunoGen product site
  5. 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
  6. Dr. Sara Hurvitz's 2011 European Society for Medical Oncology (ESMO) Presentation
  7. Ado-trastuzumab emtansine (Kadcyla) patient drug information (Chemocare)
  8. Ado-trastuzumab emtansine (Kadcyla) patient drug information (UpToDate)