Trastuzumab

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Generic Name of Trastuzumab - Learn More

Trastuzumab

Trastuzumab Precaution - What You Need to Know

Before initiating Trastuzumab, it is important for patients to consult their healthcare provider, particularly if they have any of the following conditions:

- Cardiovascular Disease: Trastuzumab can cause heart problems, including congestive heart failure (CHF), decreased left ventricular ejection fraction (LVEF), and cardiomyopathy. Patients with existing heart conditions or a history of heart failure should be closely monitored during treatment. Pre-treatment cardiac assessment and regular follow-up monitoring are essential.
- Pregnancy and Lactation: Trastuzumab is classified as Pregnancy Category D (risk to the fetus), meaning it should only be used during pregnancy if absolutely necessary. It is excreted in breast milk, so it is advised that breastfeeding should be avoided during treatment and for at least 6 months after discontinuation.
- Liver Dysfunction: Patients with liver disease or liver dysfunction should use Trastuzumab with caution, as it may increase the risk of liver toxicity.
- Allergic Reactions: Severe allergic reactions, such as hypersensitivity, may occur. Patients with known hypersensitivity to Trastuzumab or any of its components should avoid using the drug.
- Pulmonary Toxicity: Trastuzumab can rarely cause pulmonary toxicity. It is crucial to monitor patients for respiratory symptoms such as cough or shortness of breath.

Trastuzumab Indication - Uses and Benefits

Trastuzumab is a monoclonal antibody that is primarily used in the treatment of certain types of cancer, specifically those that overexpress the HER2 (human epidermal growth factor receptor 2) protein:

- Breast Cancer: It is indicated for the treatment of HER2-positive breast cancer. This includes:
- Early-stage HER2-positive breast cancer (after surgery) as part of adjuvant therapy.
- Metastatic HER2-positive breast cancer, either alone or in combination with chemotherapy agents like paclitaxel or docetaxel.
- Recurrent HER2-positive breast cancer that has spread to other areas of the body.

- Gastric Cancer: Trastuzumab is also used in combination with chemotherapy to treat HER2-positive gastric (stomach) cancer, particularly in patients with advanced or metastatic gastric cancer.

Trastuzumab Contraindications - Important Warnings

Trastuzumab should not be used in the following situations:

- Known Hypersensitivity: Patients who are allergic to Trastuzumab or any of its components should not receive the medication.
- Severe Cardiac Dysfunction: Trastuzumab is contraindicated in patients with severe heart failure or left ventricular dysfunction due to the risk of exacerbating cardiomyopathy or causing heart failure.
- Pregnancy: As Trastuzumab can cause harm to the fetus, it is contraindicated in pregnancy unless the benefits outweigh the risks. If pregnancy occurs during treatment, the drug should be discontinued immediately.

Trastuzumab Side Effects - What to Expect

Common and severe side effects of Trastuzumab include:

- Common Side Effects:
- Fatigue: Many patients experience fatigue during treatment with Trastuzumab.
- Nausea and Vomiting: These are frequent side effects, especially when used in combination with chemotherapy.
- Fever and Chills: Infusion reactions can result in fever, chills, or rigors, particularly during the initial infusion.
- Diarrhea: Diarrhea can occur in some patients, often with chemotherapy regimens.

- Serious Side Effects:
- Cardiac Toxicity: Trastuzumab can cause heart problems, including congestive heart failure, left ventricular dysfunction, and arrhythmias. Regular cardiac monitoring is required.
- Pulmonary Issues: Rare but severe pulmonary toxicity can occur, presenting as cough, dyspnea, or respiratory distress.
- Severe Infusion Reactions: Some patients may experience severe infusion-related reactions, which can include difficulty breathing, low blood pressure, or anaphylactic reactions.
- Hematologic Issues: Anemia, leukopenia, or neutropenia may occur, especially when used with chemotherapy agents.

Trastuzumab Pregnancy Category ID - Safety Information

4

Trastuzumab Mode of Action - How It Works

Trastuzumab is a monoclonal antibody that specifically targets the HER2 receptor, a protein overexpressed on the surface of some cancer cells, particularly in HER2-positive breast cancer and gastric cancer:

- HER2 Receptor Inhibition: Trastuzumab binds to the extracellular portion of the HER2 receptor and blocks its activation. By doing so, it inhibits the signaling pathways that promote cancer cell growth and survival.
- Antibody-Dependent Cellular Cytotoxicity (ADCC): Trastuzumab also stimulates the immune system, leading to antibody-dependent cellular cytotoxicity (ADCC). This process enhances the immune system’s ability to recognize and destroy HER2-positive cancer cells.
- Inhibition of Tumor Growth: Through blocking HER2 signaling and stimulating immune responses, Trastuzumab impedes tumor cell proliferation and can help shrink tumors.

Trastuzumab Drug Interactions - What to Avoid

Trastuzumab may interact with other medications, affecting either its effectiveness or causing potential side effects:

- Chemotherapy: When used with chemotherapy agents like taxanes (e.g., paclitaxel) or anthracyclines (e.g., doxorubicin), there may be an increased risk of cardiovascular toxicity, especially heart-related issues. Cardiac monitoring is essential.
- Cardiotoxic Drugs: Combining Trastuzumab with other drugs that cause heart damage, such as doxorubicin, cyclophosphamide, or other anthracyclines, can increase the risk of heart failure. Close monitoring of cardiac function is required.
- Vaccines: Immunosuppressive effects from Trastuzumab could reduce the effectiveness of live vaccines. Patients should avoid receiving live vaccines during treatment.
- Other HER2-targeting Drugs: Concomitant use with other HER2-targeted therapies (e.g., lapatinib, pertuzumab) may have an additive effect on the risk of cardiovascular issues or other side effects, so careful evaluation is needed before co-administration.

Trastuzumab Adult Dose - Recommended Dosage

The typical dosing for Trastuzumab varies based on the treatment regimen and the type of cancer:

- Initial Dose: The initial dose of Trastuzumab is typically 8 mg/kg of body weight, administered intravenously.
- Subsequent Doses: Following the initial dose, the maintenance dose is usually 6 mg/kg every 3 weeks via intravenous infusion. For patients on weekly therapy, the dose is typically reduced to 2 mg/kg once a week.

- Gastric Cancer: The dosing for gastric cancer is similar, with an initial dose of 8 mg/kg, followed by 6 mg/kg every 3 weeks.

Trastuzumab Child Dose - Dosage for Children

Trastuzumab is not commonly prescribed for pediatric patients, and its use in children has not been extensively studied. However, in cases where HER2-positive cancers are diagnosed in children, dosing is often based on body weight and follows similar guidelines as for adults. Pediatric use should be considered only under the care of a specialist with experience in pediatric oncology.

Consultation with a healthcare provider is essential before starting Trastuzumab therapy, as the medication requires careful monitoring for cardiovascular side effects, infusion reactions, and other complications, depending on the specific cancer being treated.

Trastuzumab Renal Dose - Dosage for Kidney Conditions

There is no specific dose adjustment required for Trastuzumab in patients with renal impairment, as the drug is not primarily excreted through the kidneys. However, patients with severe renal dysfunction should be monitored closely for side effects, and dose adjustments should be considered if other concurrent treatments are affecting renal function.