What Is Herceptin (trastuzumab)? What Is Herceptin For?

Editor's Choice
Main Category: Breast Cancer
Also Included In: Cancer / Oncology;  Pharma Industry / Biotech Industry;  Pharmacy / Pharmacist
Article Date: 09 Dec 2009 - 9:00 PDT

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Trastuzumab, known by the brand name Herceptin is a medication given to patients with breast cancer. It halts the growth of breast cancer and can sometimes shrink tumors.

Herceptin, which is administered intravenously, is sometimes given along with chemotherapy or on its own. Typically, the patient has already undergone two courses of chemotherapy.

According to Medilexicon's medical dictionary:

Herceptin (trastuzumab) is "a monoclonal antibody used in treating her 2 neu-positive carcinoma of breast."

Trastuzumab, made by biotech company Genentech, was approved by the FDA in 1998.

Preliminary studies showed that Herceptin improved survival rates in late-stage breast cancer - metastatic cancer. There is still controversy regarding this medication for patients with earlier stage breast cancer.

Some experts believe Herceptin's effectiveness has been overstated. Various media outlets have been accused of giving trastuzumab an undeserved miracle-drug status. These controversies and media statements have confused patients who wonder whether they should take the drug or not.

Herceptin (trastuzumab) is expensive. Some US private health insurance companies and governments where universal health care cover exists refuse to pay for Herceptin treatment. Some companies have since accepted Herceptin treatment as a covered preventative treatment. In 2010 NICE (National Institute for Health and Clinical Evidence) approved Herceptin use for some patients with advanced and early stage breast cancers. NICE decides whether a drug gets covered by the UK National Health Service (NHS).

How does Herceptin work?

Herceptin is a monoclonal antibody, it interferes with the HER2/neu receptor. Only patients with high HER2 protein levels should be given this drug. HER2 exists on the surface of some breast cancer cells. The HER receptors are proteins that are routed in the cell membrane.

HER receptors communicate molecular signals to within the cells from the surface, and switch genes on and off. HER proteins are important factors in cell growth, adhesion, migration, differentiation and survival. In breast cancers the HER2 receptor is faulty - its "on" switch never goes to "off", resulting in the uncontrollable reproduction of breast cells, causing breast cancer.

Herceptin sticks to the HER2 protein, preventing the epidermal growth factor (a protein) from getting into the cancer cells. Herceptin effectively stops the breast cancer cells from reproducing uncontrollably.

Patients without high levels of HER2 protein do not benefit from Herceptin therapy. Only approximately 20% of females with breast cancer have Herceptin-sensitive tumors. In other words, if the breast cancer does not have overactive HER2 receptors, Herceptin will have no beneficial effect. There are tests doctors can order which determine whether a patient's HER2 is over-expressed.

The best duration of adjuvant Herceptin (trastuzumab) is currently unknown. Experts say that one year of Herceptin treatment is ideal. According to clinical trial findings, extending the treatment period for longer provides the patient with no additional benefits.

Debate about treatment duration has become a relevant issue for many public health policy makers due to the high financial costs involved in the administration of this treatment for one year. Current clinical trials are in progress hoping to answer this question by directly comparing short versus long duration of therapy.

If you have a pre-existing heart condition you should not take Herceptin. Health authorities recommend that patients be assessed for heart function before considering using this drug.

Possible side effects of Herceptin include:

• Stomach pain
• Pneumonia
• Nausea and vomiting
• Heart problems
• Headaches
• Fevrer
• Flu-like symptoms
• Diarrhea
• Cough and shortness of breath
• Chest pain
• Aches and pains

Some patients may develop allergic reactions and experience breathlessness, itching and a rash. This is rare.

Most of Herceptin's side effects are treatable, often with medication.

Written by Christian Nordqvist


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