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Taking Herceptin

How long, how often, and with which other therapies¹

It is recommended that Herceptin (trastuzumab) be taken for one year. You may receive it in combination with different therapies, or on different schedules. The combination of drugs you receive, and the order in which you receive them, are known as your treatment "regimen." There are several options available for different regimens that include Herceptin, as shown below.

The choice of which regimen you receive will affect the total amount of time you will be going for infusions. You should also be aware that different chemotherapies have different side effects, so it's important to talk to your health care team about any health issues you have. This information may help them decide whether it's better for you to take one kind of chemotherapy over another.

AC→TH

If you and your doctor decide that you will receive Herceptin as part of the “AC→TH” regimen:

After surgery, you will receive two kinds of chemotherapy, known as doxorubicin (A) and cyclophosphamide (C), for 12 weeks
You will then begin to receive Herceptin weekly, along with another kind of chemotherapy known as a taxane (T)
After 12 weeks, the taxane will stop, and you will receive Herceptin alone, once every three weeks, for another nine months

TCH

If you and your doctor decide that you will receive Herceptin as part of the "TCH" regimen:

You will begin to receive Herceptin after surgery, on a once-weekly schedule. At the same time, you will be getting two kinds of chemotherapy: a taxane (T) and a carboplatin (C). Note that the "C" in TCH is different from the "C" in the AC→TH option described above
After 18 weeks, the taxane and the carboplatin will stop, and you will receive Herceptin alone, once every three weeks. This will continue until you have received one year of therapy

Herceptin given alone after all chemotherapy

You and your doctor may decide to first complete any surgery, chemotherapy, and radiation therapy that are planned, and then begin taking Herceptin. If this is the case, you will receive Herceptin once every three weeks for one year.

Your healthcare team may also choose to give you other drugs, such as hormonal therapies, during the time you are receiving Herceptin.

Talk to your healthcare team to decide which therapies and schedule are right for you.

References:
1. Herceptin Prescribing Information. Genentech, Inc. March 2009.

Who is Herceptin for?

Herceptin is approved for the adjuvant treatment of HER2-overexpressing, node-positive or node-negative (ER/PR-negative or with one high-risk feature)^† breast cancer. Herceptin can be used several different ways:

As part of a treatment regimen including doxorubicin, cyclophosphamide, and either paclitaxel or docetaxel
With docetaxel and carboplatin
As a single agent following multi-modality anthracycline-based therapy

† High-risk is defined as ER/PR positive with one of the following features: tumor size >2 cm, age <35 years, or tumor grade 2 or 3.

What important safety information should I know about Herceptin?

Herceptin treatment can result in heart problems, including those without symptoms (reduced heart function) and those with symptoms (congestive heart failure). The risk and seriousness of these heart problems were highest in people who received both Herceptin and a certain type of chemotherapy (anthracycline). Your doctor will stop or strongly consider stopping Herceptin if you have a significant drop in your heart function.

You should be monitored for decreased heart function before your first dose of Herceptin, and frequently during the time you are receiving Herceptin and after your last dose of Herceptin. If you must permanently or temporarily stop Herceptin due to heart problems, you should be monitored more frequently. In one study with Herceptin and certain types of chemotherapy, an inadequate blood supply to the heart occurred.

Some patients have had serious infusion reactions and lung problems; fatal infusion reactions have been reported. In most cases, these reactions occurred during or within 24 hours of receiving Herceptin. Your Herceptin infusion should be temporarily stopped if you have shortness of breath or very low blood pressure. Your doctor will monitor you until these symptoms go away. If you have a severe allergic reaction, swelling, lung problems, inflammation of the lung, or severe shortness of breath, your doctor may need to completely stop your Herceptin treatment.

Worsening of low white blood cell counts associated with chemotherapy has also occurred.

Herceptin can cause low amniotic fluid levels and harm to the fetus when taken by a pregnant woman.

The most common side effects associated with Herceptin were fever, nausea, vomiting, infusion reactions, diarrhea, infections, increased cough, headache, fatigue, shortness of breath, rash, low white and red blood cells, and muscle pain.

Because everyone is different, it is not possible to predict what side effects any one person will have. If you have questions or concerns about side effects, talk to your doctor.

Please see the Herceptin full Prescribing Information including Boxed WARNINGS and additional important safety information.