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Trastuzumab: Brands, Price & Uses in Bangladesh
Trastuzumab is a HER2-targeted monoclonal antibody indicated for the treatment of certain HER2-overexpressing cancers, confirmed by an approved HER2 test prior to initiation.
About Trastuzumab
Indications of Trastuzumab
Trastuzumab is a HER2-targeted monoclonal antibody indicated for the treatment of certain HER2-overexpressing cancers, confirmed by an approved HER2 test prior to initiation.
Established / FDA-approved uses
- Adjuvant breast cancer: HER2-overexpressing, node-positive or high-risk node-negative breast cancer, as part of a treatment regimen containing doxorubicin, cyclophosphamide, and either paclitaxel or docetaxel, or with docetaxel and carboplatin, or as a single agent following multi-modality anthracycline-based therapy.
- Metastatic breast cancer: HER2-overexpressing metastatic breast cancer, in combination with paclitaxel for first-line treatment, or as a single agent in patients who have received one or more prior chemotherapy regimens for metastatic disease.
- Metastatic gastric or gastroesophageal junction (GEJ) adenocarcinoma: HER2-overexpressing metastatic gastric or GEJ adenocarcinoma, in combination with cisplatin and a fluoropyrimidine (capecitabine or 5-fluorouracil), in patients who have not received prior treatment for metastatic disease.
Trastuzumab must only be used in patients whose tumors have confirmed HER2 overexpression or gene amplification, as efficacy depends entirely on HER2-positive status.
Dosage & Administration of Trastuzumab
Trastuzumab dosing is indication-specific and must be individualized by the treating oncologist. It is given as an intravenous infusion only — never as an intravenous push or bolus.
| Indication | Loading dose | Maintenance dose | Duration |
|---|---|---|---|
| Adjuvant breast cancer (Regimen A) | 4 mg/kg IV over 90 minutes | 2 mg/kg IV weekly over 30 minutes (with paclitaxel/docetaxel), then 6 mg/kg every 3 weeks | Total of 52 weeks |
| Adjuvant breast cancer (Regimen B) | 8 mg/kg IV over 90 minutes | 6 mg/kg IV every 3 weeks over 30–90 minutes | Total of 52 weeks |
| Metastatic breast cancer | 4 mg/kg IV over 90 minutes | 2 mg/kg IV weekly over 30 minutes | Until disease progression or unacceptable toxicity |
| Metastatic gastric/GEJ adenocarcinoma | 8 mg/kg IV over 90 minutes | 6 mg/kg IV every 3 weeks over 30–90 minutes | Until disease progression or unacceptable toxicity |
If a scheduled dose is missed or delayed, the treating physician determines whether a reloading dose is required based on the interval since the last dose. See Administration for infusion technique and monitoring, and Reconstitution for preparation of the intravenous powder for injection.
Side Effects of Trastuzumab
Serious adverse effects of Trastuzumab — cardiomyopathy, infusion reactions, pulmonary toxicity, and embryo-fetal toxicity — are described fully in Precautions and Warnings and are not repeated here.
Common side effects
- Fever, chills, and flu-like symptoms, especially with the first infusion
- Headache and fatigue
- Nausea, vomiting, and diarrhea
- Infections (including upper respiratory and urinary tract infections)
- Rash
- Insomnia
- Neutropenia, anemia, and thrombocytopenia (more common when combined with chemotherapy)
- Stomatitis and weight loss (particularly reported in gastric cancer treatment)
Patients should promptly report shortness of breath, swelling of the legs, palpitations, unusual bruising or bleeding, or persistent fever to their treating physician.
Contraindications of Trastuzumab
Trastuzumab is contraindicated in patients with:
- Known hypersensitivity to Trastuzumab or to murine (mouse) proteins, or to any component of the formulation.
Trastuzumab should not be initiated in patients who are pregnant or planning pregnancy because of confirmed risk of fetal harm (see Pregnancy and Lactation); this is a strict avoidance rather than a formal labeled contraindication in all regulatory labels, so the treating physician must weigh this carefully before use.
Frequently Asked Questions about Trastuzumab
What is Trastuzumab used for?
Trastuzumab is a targeted monoclonal antibody used to treat HER2-positive (HER2-overexpressing) breast cancer, both in the adjuvant (after surgery) setting and in metastatic disease, and HER2-positive metastatic gastric or gastroesophageal junction cancer, usually combined with other chemotherapy agents.
How is Trastuzumab given?
Trastuzumab is given only as an intravenous infusion in a hospital or clinic setting, never as an injection you can give yourself at home. The first (loading) dose is infused slowly over about 90 minutes while you are monitored closely; later doses may be given faster if the earlier infusions were well tolerated.
What are the most serious risks of Trastuzumab?
Trastuzumab carries boxed warnings for heart problems (decreased heart pumping function and heart failure), severe infusion reactions (including rare but serious allergic reactions), lung problems, and harm to a developing baby if used during pregnancy. Your doctor will check your heart function before and during treatment and monitor you closely during each infusion.
Can Trastuzumab be used during pregnancy?
No. Trastuzumab should not be used during pregnancy because it can cause serious harm to the fetus, including a dangerous reduction in amniotic fluid. Women who can become pregnant should use effective contraception during Trastuzumab treatment and for at least 7 months after the last dose, and should tell their doctor immediately if they become pregnant.
What should I tell my doctor before starting Trastuzumab?
Tell your doctor about any history of heart disease, high blood pressure, lung disease, previous chemotherapy (especially anthracyclines like doxorubicin), current pregnancy or breastfeeding, and all other medicines you are taking, so they can assess whether Trastuzumab is safe for you and plan appropriate monitoring.
What if a dose of Trastuzumab is missed or an overdose is suspected?
If a scheduled Trastuzumab infusion is missed, contact your treatment team to reschedule — do not try to make up the dose on your own. If an overdose of Trastuzumab is suspected, seek immediate medical attention or contact emergency services, as you may need close monitoring for heart, lung, or infusion-related complications.
Disclaimer
The information provided is accurate to the best of our knowledge, but it does not replace professional medical advice. We cannot guarantee its completeness or accuracy, and the absence of specific information about a drug should not be taken as an endorsement. We are not responsible for any consequences arising from this information, so please consult a healthcare professional for any concerns or questions.