Trastuzumab (green) bound
to HER2 protein
Trastuzumab, better known by its trade name, Herceptin, was one of the first targeted cancer therapies approved in the United States.
The product of decades worth of basic, US government-funded research as well as a determined researcher named Dennis Slamon, Trastuzumab is one of the biggest breakthrough cancer treatments ever to reach the market and has positively changed the lives of thousands and thousands of women with cancer.
Herceptin Drug Profile
- Class: Monoclonal antibody
- Mechanism of action: Trastuzumab binds to the antigen of the epidermal growth factor receptor 2 (HER2) overexpressed on many cancer cells. It may also have other antuproliferative actions.
- Treatment type: Targeted treatment; chemopreventive
- US approval: 1998
- Synonyms: Herceptin
- FDA Use-in-Pregnancy Rating: Category B
What Herceptin is effective for and why
Herceptin benefits a minority of patients with breast cancer, those whose tumor overexpresses the HER-2 gene (about 25% of breast cancers). It is also used in breast cancer prevention and as a treatment for some ovarian cancers.
Side effects
One of the more significant aspects of Herceptin when it first came to market were the limited side effects, including a rather low toxicity profile. Now that the drug has been around for over decade and it has been subject to multiple large-scale drug trials, some of the side effects are starting to come to light, although on the whole patients taking this drug experience fewer non-specific side effects than with traditional chemotherapy. Perhaps the most important side effect to note is Herceptin's potential to cause severe cardiac problems, including heart failure.
Sources
- Guide to Cancer Drugs, American Cancer Society
- Cancer Drug Manual, BC Cancer Agency
- Boyiadzis, Michael M. et al. Hematology-Oncology Therapy. 2007. New York: McGraw Hill, Medical Publishing Division.
- Goozner, Merrill. The $800 Million Pill. 2005. Berkeley: University of California Press.
Significant studies relating to trastuzumab
- Piccart-Gebhart MJ et al. "Trastuzumab after adjuvant chemotherapy in HER2-positive breast cancer." N Engl J Med 2005;353:1659–1672.
- Slamon D, Eiermann W, Robert N et al. "Phase III randomized trial comparing doxorubicin and cyclophosphamide followed by docetaxel (AC-T) with doxorubicin and cyclophosphamide followed by docetaxel and trastuzumab (AC-TH) with docetaxel, carboplatin and trastuzumab (TCH) in HER2 positive early breast cancer patients: BCIRG 006 study." Breast Cancer Res Treat 2005;94(suppl 1):S5
- Baselga J et al. Adjuvant Trastuzumab: A milestone in the Treatment of HER-2 Positive Early Breast Cancer." Oncologist 2006;11 Suppl 1:4-12. Review
