Trastuzumab
Trastuzumab is standard of care in the treatment of
human epidermal growth factor receptor (HER)-2+ early and advanced breast cancer. Recently, it has been
approved for the treatment of HER-2+ advanced gastric cancer.
Trastuzumab is an IgG1 humanized
monoclonal antibody administered by intravenous infusion on a weekly or three weekly schedule. In all registered indications,
trastuzumab is almost always given in combination with chemotherapy. In hormonal receptor-positive breast
cancer in postmenopausal women,
trastuzumab can be combined with an aromatase inhibitor. Main toxicity is reduction in the left ventricular ejection fraction, which in a minority of patients can become symptomatic, but in many patients is at least partly reversible. Long-term safety needs to be further determined.
Trastuzumab (Herceptin®; F. Hoffmann-La Roche, Basel, Switzerland) is registered for the treatment of
human epidermal growth factor receptor (HER)-2+ metastatic breast cancer, for adjuvant treatment of localized HER-2+ breast cancer, and for HER-2+ metastatic adenocarcinoma of the stomach or gastroesophageal junction. In the U.S. and European Union (EU),
trastuzumab is indicated for breast
cancer patients with a proven amplification of the HER-2 oncogene or overexpression of the HER-2 protein in the tumor. Overexpression of HER-2 or amplification of HER-2 is associated with adverse disease prognosis and shorter overall and disease-free survival times
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