Trastuzumab is a monoclonal antibody used in the treatment of certain types of breast and stomach cancer. It is specifically targeted against the HER2/neu (human epidermal growth factor receptor 2) protein, which is overexpressed in some cancers. Here are some key points about trastuzumab:
Indications:
1. Breast Cancer:
Trastuzumab is used for HER2-positive breast cancer, which accounts for about 20-25% of all breast cancers. It can be used in various settings, including:
- Adjuvant treatment (after surgery to reduce the risk of recurrence)
- Neoadjuvant treatment (before surgery to shrink tumors)
- Metastatic treatment (for advanced or metastatic disease)
2. Gastric Cancer:
It is also used for HER2-positive metastatic gastric or gastroesophageal junction adenocarcinoma.
Mechanism of Action:
Trastuzumab works by binding to the HER2 receptor on the surface of cancer cells, inhibiting the signaling pathways that promote cell growth and survival. It also recruits immune cells to attack and kill the cancer cells (antibody-dependent cell-mediated cytotoxicity, ADCC).
Administration:
Trastuzumab is typically administered intravenously (IV), although a subcutaneous formulation is also available. The treatment schedule varies depending on the specific regimen and the stage of the disease.
Side Effects:
Common side effects include:
- Fever
- Chills
- Nausea
- Headache
- Fatigue
- Cardiotoxicity (heart damage, particularly reduced left ventricular ejection fraction)
Monitoring:
Patients receiving trastuzumab, especially those with a history of heart disease, should be closely monitored for cardiac function, typically through regular echocardiograms or MUGA scans.
Brand Names:
Trastuzumab is marketed under the brand name Herceptin and also available as biosimilars.
Combination Therapy:
Trastuzumab is often used in combination with other chemotherapy agents, such as paclitaxel, docetaxel, or pertuzumab, to enhance its efficacy.
Development and Approval:
Trastuzumab was developed by Genentech and received FDA approval in 1998 for the treatment of HER2-positive breast cancer.
Biosimilars:
Several biosimilars of trastuzumab have been approved, offering potentially more affordable options for patients.
Trastuzumab has significantly improved outcomes for patients with HER2-positive cancers and remains a cornerstone in the treatment of these malignancies.