Trastuzumab

Therapeutic indications

Trastuzumab is indicated for:

HER2-positive breast cancer

Population group: only adults (18 years old or older)

Metastatic breast cancer

Trastuzumab is indicated for the treatment of adult patients with HER2 positive metastatic breast cancer (MBC):

As monotherapy for the treatment of those patients who have received at least two chemotherapy regimens for their metastatic disease. Prior chemotherapy must have included at least an anthracycline and a taxane unless patients are unsuitable for these treatments. Hormone receptor positive patients must also have failed hormonal therapy, unless patients are unsuitable for these treatments.
In combination with paclitaxel for the treatment of those patients who have not received chemotherapy for their metastatic disease and for whom an anthracycline is not suitable.
In combination with docetaxel for the treatment of those patients who have not received chemotherapy for their metastatic disease.
In combination with an aromatase inhibitor for the treatment of postmenopausal patients with hormone-receptor positive MBC, not previously treated with trastuzumab.

Early breast cancer

Trastuzumab is indicated for the treatment of adult patients with HER2 positive early breast cancer (EBC).

Following surgery, chemotherapy (neoadjuvant or adjuvant) and radiotherapy (if applicable).
Following adjuvant chemotherapy with doxorubicin and cyclophosphamide, in combination with paclitaxel or docetaxel.
In combination with adjuvant chemotherapy consisting of docetaxel and carboplatin.
In combination with neoadjuvant chemotherapy followed by adjuvant trastuzumab therapy, for locally advanced (including inflammatory) disease or tumours >2 cm in diameter.

Trastuzumab should only be used in patients with metastatic or early breast cancer whose tumours have either HER2 overexpression or HER2 gene amplification as determined by an accurate and validated assay.

For this indication, competent medicine agencies globally authorize below treatments (click for details):

8 mg/kg body weight followed by 6 mg/kg once every 3 weeks or 4 mg/kg body weight followed by 2 mg/kg every week

HER2 positive metastatic adenocarcinoma of the stomach or gastro-oesophageal junction

Population group: only adults (18 years old or older)

Trastuzumab in combination with capecitabine or 5-fluorouracil and cisplatin is indicated for the treatment of adult patients with HER2 positive metastatic adenocarcinoma of the stomach or gastro-oesophageal junction who have not received prior anti-cancer treatment for their metastatic disease.

Trastuzumab should only be used in patients with metastatic gastric cancer (MGC) whose tumours have HER2 overexpression as defined by IHC2+ and a confirmatory SISH or FISH result, or by an IHC3+ result. Accurate and validated assay methods should be used.

For this indication, competent medicine agencies globally authorize below treatments (click for details):

8 mg/kg body weight followed by 6 mg/kg body weight once every 3 weeks

Contraindications

Trastuzumab is contraindicated in the following cases:

Severe dyspnoea

Dyspnea

Lactation

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