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Herceptin - A Targeted Biologic Therapy for Breast Cancer

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Updated December 21, 2012

Herceptin, generic name trastuzumab, is a protein that targets and binds to the HER2 protein (human epidermal growth factor receptor2). HER2 is found on the outer surface of 25 to 30% of breast cancer cells. Herceptin interferes with the HER2-positive tumor cells, preventing their growth, and causing them to die. It is a white to pale yellow fluid given in a chemotherapy infusion, to fight breast, prostate, colon and ovarian cancers.

Herceptin for Breast Cancer Treatment:

This drug is given to treat HER2-positive metastatic breast cancer. Herceptin can be given in combination with Taxol (paclitaxel) if the patient has not already been treated with chemotherapy. Herceptin can also be given by itself to treat HER2-positive breast cancer, if the patient has already had Adriamycin or Rubex (anthracycline) chemotherapy, or Adriamycin plus Cytoxan or Neosar (cyclophosphamide) chemotherapy drugs.

How Herceptin Works:

Herceptin is part of a new class of drugs that are called targeted (biologic) therapies. This drug works by hunting down only those cancer cells that have HER2/neu receptors on their outer surface. The HER2 gene makes a protein receptor on the surface of a tumor cell. This receptor signals the cell to divide and multiply. When there is too much HER2 in breast cancer tissue, cell division goes out of control, growing much too quickly. Herceptin attaches to the HER2 receptors and blocks the growth signal, preventing more cell division, and slowing the progress of the cancer.

How Herceptin Is Given:

Herceptin is given in a chemotherapy infusion. Your first dose will be given slowly in a 90-minute session, to see how well you tolerate the drug, and to watch for allergic reactions. If you do well with Herceptin, your following infusions can be given in 30-minute sessions.

Some Common Side Effects:

  • Chills or fever
  • Weakness
  • Nausea
  • Body pain
Less Common Side Effects
  • Headache
  • Abdominal pain
  • Back pain
  • Infection
  • Flu-like symptoms
  • Diarrhea
  • Vomiting
  • Coughing
  • Shortness of breath
  • Cold symptoms
  • Sleep problems
  • Skin rash
  • Dizziness
  • Swelling of the feet, ankles or hands
  • Neuropathy (tingling of fingers and toes)

Call Your Doctor if You Have These Symptoms:

If you have an allergic reaction to Herceptin, call your doctor. Allergic symptoms include:
  • Extreme shortness of breath
  • Struggling to breathe
  • Wheezing
  • Swelling of throat or lips
  • Hives (rash and itching)
Urgent Symptoms Include:
  • Shortness of breath
  • Chest pain

Possible Risks of Using Herceptin:

Herceptin can cause heart problems and congestive heart failure. You should have a test to check your left ventricular function before starting Herceptin treatment. The risk of heart problems increases if you are being treated with Adriamycin and Cytoxan as well as Herceptin.

Do Not Take Herception If:

  • you are allergic to Herceptin
  • you are pregnant or breastfeeding

Recommendations During Treatment:

Most oncologists recommend that you avoid the use of alcohol, tobacco, or caffeine during treatment with Herceptin. Caffeine causes drying of your tissues, which only adds to the drying effects already caused by your chemo drugs. Tell your health care team if you are using tobacco, alcohol, or recreational drugs, and ask for help in quitting the use of these drugs. Practice contraception while in treatment with Herceptin, because this drug may cause harm to the baby. If you are already pregnant, be sure to tell your doctor.

Self-Care Tips While Taking Herceptin:

  • Stay well-hydrated by drinking two or three quarts of fluids every 24 hours
  • If needed, take your anti-nausea medications as directed
  • Some patients experience dizziness and drowsiness, so take it easy until these symptoms subside
  • If you have flu-like symptoms, pile on the blankets and drink lots of fluids (sports drinks can help)
  • Aches and pains can be relieved with acetaminophen or ibuprofen, but check with your doctor first
  • Rest as much as you can
  • Eat a good, nutritious diet
Source: FDA. Drug Information. Trastuzumab Product Label Details. Updated: September 1998.
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  5. Targeted Biologic Therapies
  6. Herceptin (Trastuzumab) - Targeted Biologic Therapy for Breast Cancer

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