Trastuzumab
Introduction To Trastuzumab
Trastuzumab is used in the treatment of breast and stomach cancer. It works by killing the cancer cells by inhibiting HER2 (human epidermal growth factor receptor protein).
Trastuzumab is given as an injection by a qualified medical professional. Your doctor will decide what dose is necessary and how often you need to take it. This will depend on what you are being treated for and may change from time to time. You should take it exactly as your doctor has advised. Taking it in the wrong way or taking too much can cause very serious side effects. It may take several weeks or months for you to see or feel the benefits but do not stop taking it unless your doctor tells you to.
The most common side effects of this medicine include nausea, headache, rash, insomnia, and infection. This medicine may reduce the number of blood cells (decrease red blood and white blood cells) in your blood, thereby, increasing the susceptibility to infections. Regular blood tests are required to check your blood cells along with heart, liver, and blood uric acid levels. You must have to inform your doctor if you experience breathlessness, cough, shivering, swelling of legs and arm.
Many other medicines can affect, or be affected by, this medicine so let your healthcare team know all medications you are using. This medicine is not recommended during pregnancy or while breastfeeding. The use of effective contraception by both males and females during treatment is important to avoid pregnancy.
Uses of Trastuzumab
- Breast cancer
- Stomach cancer
Benefits of Trastuzumab
Breast cancer
Trastuzumab is used to treat breast cancer when other medicines have failed to
show significant improvement. It helps to stop cancer growth and further
spread and relieves the symptoms of breast cancer such as breast lumps, bloody
discharge from nipple or changes in the shape or texture of the breast. This
medicine is given as an injection by a doctor or nurse. Follow your doctor’s
instructions carefully to get the most benefit.
Stomach cancer
Stomach cancer also known as gastric cancer, may occur in the inner lining
(called mucosa) of the stomach or in the walls of the stomach. These are of
various kinds depending on the origin, affected area and severity of the
cancer. Trastuzumab helps to kill the cancer cells and also stops their further
growth and spread. Follow your doctor’s instructions carefully to get the most
benefit.
Side effects of Trastuzumab
Most side effects do not require any medical attention and disappear as your body adjusts to the medicine. Consult your doctor if they persist or if you’re worried about them
Common side effects of Eleftha
- Anemia (low number of red blood cells)
- Chills
- Common cold
- Cough
- Decreased blood cells (red cells, white cells, and platelets)
- Diarrhea
- Fatigue
- Fever
- Headache
- Heart failure
- Infection
- Insomnia (difficulty in sleeping)
- Mucosal inflammation
- Nausea
- Rash
- Stomatitis (Inflammation of the mouth)
- Taste change
- Upper respiratory tract infection
- Weight loss
How to use Trastuzumab
Your doctor or nurse will give you this medicine. Kindly do not self administer.
How Trastuzumab works
Trastuzumab is a recombinant IgG1 monoclonal antibody. It works against the HER2 (human epidermal growth factor receptor protein) receptors which are responsible for the over-proliferation of cancer cells in breast cancer and stomach cancer cells. It destroys the cancer cells by inhibiting HER2. It also inhibits various cancer-causing downstream signaling pathways.
Quick tips
- It is given as an injection into your vein or under the skin, usually over 1 hour.
- Use effective contraception method to prevent pregnancy while taking this medicine and for 7 months after you stop the treatment.
- Your doctor will monitor your heart regularly while taking this medicine. Inform your doctor if you notice symptoms such as breathlessness, cough, shivering, swelling of legs and arm.
- Inform your doctor if you are pregnant, planning pregnancy or breastfeeding.
Safety Advice
PregnancyCONSULT YOUR DOCTOR
Can I take Trastuzumab if I’m pregnant?
Trastuzumab is unsafe to use during pregnancy as there is definite evidence of risk to the developing baby. However, the doctor may rarely prescribe it in some life-threatening situations if the benefits are more than the potential risks. Please consult your doctor.
BreastfeedingCONSULT YOUR DOCTOR
Can I take Trastuzumab if I’m breastfeeding?
Trastuzumab is probably unsafe to use during breastfeeding. Limited human data suggests that the drug may pass into the breastmilk and harm the baby.
AlcoholUNSAFE
Is drinking alcohol while taking Trastuzumab safe?
Trastuzumab may cause excessive drowsiness with alcohol.
DrivingCONSULT YOUR DOCTOR
Can I drive after taking Trastuzumab?
It is not known whether Trastuzumab alters the ability to drive. Do not drive if you experience any symptoms that affect your ability to concentrate and react.
KidneySAFE IF PRESCRIBED
Can I take Trastuzumab if I have/had kidney diseases?
Trastuzumab is probably safe to use in patients with kidney disease. Limited data available suggests that dose adjustment of Trastuzumab may not be needed in these patients. Please consult your doctor.
LiverCONSULT YOUR DOCTOR
Can I take Trastuzumab if I have/had liver diseases?
There is limited information available on the use of Trastuzumab in patients with liver disease. Please consult your doctor.
Frequently Asked Questions
Q. What are the serious side effects of Trastuzumab?
There are various side effects related to Trastuzumab such as sore throat, fever, chills, excessive tiredness, pale skin, nosebleeds, and other unusual bruising or bleeding. One can also experience stomach pain, seizures, hallucinations, muscle cramps, and spasms. Along with that, nausea or vomiting, loss of appetite, fatigue, rapid heart beat, discoloration of urine; decreased amount of urine, difficulty in urinating, pain when urinating, and other signs of infection can also be observed with the use of Trastuzumab. You should call your doctor immediately if you notice any such symptoms.
Q. How long after Trastuzumab therapy can I get pregnant?
Women of child-bearing age should use effective contraception during Trastuzumab therapy and for 7 months after completing the treatment. You can plan your pregnancy after 7 months of treatment with Trastuzumab.
Q. How long should Trastuzumab be taken?
Patients with early breast cancer should take Trastuzumab for 1 year or until disease recurs, whichever occurs first. It is not advised to extend the treatment beyond 1 year in patients of early breast cancer.
Q. Is fasting required before administering Trastuzumab?
No, fasting is not required before administering Trastuzumab. It should be given under the guidance of a doctor who is experienced in giving cancer chemotherapy and should be given only by a healthcare professional.
Q. How is Trastuzumab given, intravenously or intramuscularly?
There are 2 different formulations available for administration of Trastuzumab, one is given as an infusion into a vein (intravenous infusion) and the other is given as an injection under the skin (subcutaneous injection). It is important to check the product labels to ensure that the correct formulation is being given as prescribed. Trastuzumab intravenous formulation is not for subcutaneous use and should be given as an intravenous infusion only. Your doctor may consider switching your Trastuzumab intravenous treatment to Trastuzumab subcutaneous treatment (and vice versa) if considered appropriate for you.
Q. Can Trastuzumab be given to HER2 negative cancer patients?
No, Trastuzumab cannot be given in patients with HER2 negative cancer cells. Trastuzumab belongs to class of monoclonal antibody. It binds selectively to a protein called human epidermal growth factor receptor 2 (HER2). HER2 is found, in large amounts, on the surface of some cancer cells. When Trastuzumab binds to HER2, it stops the growth and spread of the cancer cells. Therefore, it is only effective in HER2 positive patients (in which HER2 is present) and will not be beneficial for HER2 negative patients (in which HER2 is not present).
Q. Why has my doctor advised for investigations of heart?
Trastuzumab when used with anthracycline class of anti-cancer medicines (eg doxorubicin) may adversely affect your heart. Hence, your doctor needs to check the health of your heart initially before starting treatment and during treatment.
Q. How frequently heart investigations are required?
Heart investigations should be performed at the starting of the treatment. It should be repeated every 3 months during treatment and every 6 months after the discontinuation of treatment until 24 months from the last administration of Trastuzumab. Those patients who already have heart-related problems will require investigations every 12 weeks.
References
Written By:
Dr Advikka Ridhy
MBBS
RMO, Aster MIMS
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