Trastuzumab is a drug which can be used in the treatment of certain types of breast cancer. It is more commonly known by the brand name Herceptin®. The drug was approved for use by the United States Food and Drug Administration (FDA) in 1998. For patients with breast cancers which could benefit from the use of trastuzumab, the drug comes with a very high price tag, especially since it is usually combined with other costly therapies. Insurance companies may not opt to cover trastuzumab, because they may feel that the cost of the drug does not outweigh the potential benefits for the patient.
This drug targets a particular receptor found in the breast known as the human epidermal growth factor receptor 2 (HER2). Around 25% of breast cancers are HER2+, which means that the patient's body is overexpressing the receptor. Overexpression results in uncontrolled cell growth, and the rapid growth of cancerous tumors in the breast. HER2+ cancers are notorious for being extremely aggressive, making drugs which target such cancers very appealing.
When trastuzumab is administered, the drug blocks the receptor, which means that cancer cells cannot duplicate themselves. The drug may be recommended to people with metastatic breast cancer to slow or stop the spread of the tumors, and it may also be used in combination with radiation to prevent the recurrence of the cancer by ensuring that the receptor is suppressed.
Patients receive this drug by infusion, typically in a clinic or hospital setting. The first infusion of the drug takes around an hour and a half, and the patient is usually asked to stay so that monitoring for signs of adverse reactions can take place. If the patient tolerates the trastuzumab, future treatments can be administered more quickly, taking around half an hour. Patients will still need to stay so that medical treatment can be provided if they experience a bad reaction after administration, and they need to attend regular check ups.
The most serious side effect associated with trastuzumab usage is damage to the heart. Patients can develop cardiomyopathy, a condition caused by a weakened heart muscle which is very serious. In patients with existing heart conditions, trastuzumab may not be recommended. The drug can also exasperate the symptoms of pulmonary conditions. Because of these risks, this cancer treatment must be carefully monitored at the time of administration to confirm that the patient gets the correct dosage and that signs of reactions are promptly addressed.