Herceptin® (trastuzumab) for breast cancer

Trastuzumab| (also known as Herceptin®) is a treatment that may be given to some women with breast cancer. It is a type of drug known as a monoclonal antibody. It works by attaching to HER2| receptors (proteins) on the surface of breast cancer cells. This stops the cancer cells from dividing and growing. It may also allow the body’s defences to fight better against the cancer cells.

Herceptin can reduce the chance of breast cancer coming back after initial treatment for early breast cancer. However, it is only effective for women whose breast cancer cells have a large number of the HER2 receptors on their surface. This is known as being HER2-positive. Around 1 in 5 women (20%) with breast cancer are HER2-positive. When your breast cancer is diagnosed, the cells will be tested for the HER2 protein.

In women who have early breast cancer and are HER2-positive, Herceptin may be used alongside, or after, other treatments.

Side effects are usually mild, but some women may have:

• flu-like symptoms
• diarrhoea
• headaches
• an allergic reaction.

In some women, Herceptin may cause damage to the heart muscle, which could lead to heart failure. If this happens the Herceptin® will be stopped. Usually, the effect on the heart is mild and reversible. Because the long term effects of any heart damage is not known, Herceptin is not given to women who have serious heart problems. You can discuss with your doctor whether Herceptin may be a suitable treatment for you.

 

 

Herceptin and early breast cancer

Recent research suggests that Herceptin is useful for women with early breast cancer to help reduce the risk of the cancer coming back. It is currently known that chemotherapy and/or hormonal therapy can reduce this risk. A number of research trials looked at giving Herceptin alongside chemotherapy (comparing the results of this with those of using chemotherapy alone) to see if this further reduced the risk of cancer coming back. The results of the trials were very promising: the cancer came back in half as many women who had Herceptin combined with chemotherapy, compared to those who had chemotherapy alone.

Herceptin was licensed in the UK for early breast cancer in 2006. The National Institute for Health and Clinical Excellence (NICE), which advises doctors on the prevention and treatment of ill-health, produced guidance on the use of Herceptin for women with HER2 positive early breast cancer in June 2006. The guidance states that Herceptin should be considered as a possible treatment after surgery and adjuvant chemotherapy (and radiotherapy, if appropriate). The guidance recommends that Herceptin is given every three weeks for one year.

Herceptin and secondary breast cancer

Herceptin is also licensed to treat secondary or advanced breast cancer| (cancer that has spread). It can be used on its own or in combination with chemotherapy.

In 2002, NICE published guidance on Herceptin for women with secondary breast cancer and approved its use in particular circumstances:

• Women with HER2 positive advanced breast cancer who have not had any previous chemotherapy treatment and can’t have a type of chemotherapy called an anthracycline (eprirbicin or doxorubicin) should be treated with Herceptin and a chemotherapy called Taxol.
• Women who have had two or more previous chemotherapy treatments which included an anthracylcline drug (epirubicin or doxorubicin) and a taxane (Taxol or Docetaxel) should have Herceptin alone.