Dangerous Drug: Trastuzumab(trass too zoo’ mab)
Herceptin
PREGNANCY CATEGORY D
Drug Classes
Antineoplastic
Monoclonal antibody (anti-HER2)
Therapeutic Actions
Humanized monoclonal antibody to the human epidermal growth factor receptor 2 (HER2) protein. This protein is often overexpressed in patients with aggressive, metastatic breast cancer.
Indications
Treatment of metastatic breast cancer with tumors that overexpress HER2 protein as a first-line therapy in combination with paclitaxel and as a single agent in second- and third-line therapies
Adjunct treatment of patients with HER2-overexpressing breast cancer in combination with doxorubicin, cyclophosphamide, and either docetaxol or paclitaxel; in combination with docetaxol and carboplatin; as a single agent following multimodality anthracycline-based therapy
Part of combination therapy for treatment of metastatic gastric cancer when it is HER2 positive
NEW INDICATION: Unlabled use: Treatment of ductal carcinoma in situ
Contraindications and Cautions
Contraindicated with allergy to trastuzumab or any component of the drug, breast cancers without HER2 overexpression.
Use cautiously with known cardiac disease, bone marrow depression, lactation, pregnancy.
Available Forms
Powder for injection—440 mg
Dosages
Adults
Metastatic HER2 overexpressing breast cancer: Initially, 4 mg/kg IV once by IV infusion over 90 min. For maintenance, 2 mg/kg IV once weekly over at least 30 min as tolerated. Do not exceed 500 mg/dose.
Adjuvant treatment: During and after completion of doxorubicin and cyclophosphamide therapy, paclitaxel, docetaxel, or docetaxel/carboplatin therapy, give trastuzumab weekly for a total of 52 wk. Initial dose, 4 mg/kg over 90 min by IV infusion; maintenance dose, 2 mg/kg over 30 min by IV infusion weekly for first 12 wk (paclitaxel or docetaxol) or 18 wk (docetaxol/carboplatin). Or, initial dose following multi-modality anthracycline-based regimens, 8 mg/kg over 90 min by IV infusion; then 6 mg/kg over 30–90 min by IV infusion every 3 wk for a total of 52 wk.
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