Products
Trastuzumab is commercially available as a lyophilizate for preparation of an infusion concentrate (Herceptin, biosimilars). It has been approved in many countries since 1999 (US: 1998, EU: 2000). In 2016, an additional solution for subcutaneous injection for breast cancer therapy was released in many countries (Herceptin subcutaneous). It was available earlier in other countries.
Structure and properties
Trastuzumab is a recombinant, humanized IgG1κ monoclonal antibody. It is produced by biotechnological methods.
Effects
Trastuzumab (ATC L01XC03) has antiproliferative and cytotoxic properties. The effects are due to binding to the extracellular domain of human epidermal growth factor receptor 2 (HER2). HER2 is a transmembrane tyrosine kinase receptor that belongs to the EGFR family. HER2 is overexpressed in up to one-third of breast cancers. Antibody binding to the receptor inhibits cancer cell proliferation and triggers antibody-dependent cell-mediated cytotoxicity.
Indications
- Breast cancer
- Metastatic gastric carcinoma or carcinoma of the gastroesophageal junction.
Dosage
According to the SmPC. The drug is administered either as an intravenous infusion or subcutaneously, depending on the preparation.
Contraindications
- Hypersensitivity
- Combination with anthracyclines
- Resting dyspnea
For complete precautions, see the drug label.
Interactions
An interaction with doxorubicin has been described.
Adverse effects
The most common possible adverse effects include (selection):
- Infectious diseases
- Headache, fatigue
- Diarrhea, nausea, lack of appetite, taste disorders.
- Fever, chills
- Heart failure
- Sleep disorders
- Cough
- Skin rash
- Neutropenia, anemia, thrombocytopenia.