Trastuzumab for HER2-Positive Metastatic Breast Cancer: Clinical and Economic Considerations

Abstract

Trastuzumab is a recombinant humanized monoclonal antibody that selectively targets the extra-cellular domain of the HER2 receptor. It was approved by the FDA in September 1998 as the first targeted therapy for HER2-positive metastatic breast cancer, and has since led to significant improvements in the overall prognosis for patients with HER2-positive metastatic disease. The favourable benefit/risk profile associated with palliative trastuzumab has been demonstrated in a number of clinical trials that examined trastusumab as monotherapy or in combination with chemotherapy, endocrine therapy and other HER2 targeted agents. The clinical benefits of trastuzumab, however should also be examined within the context of its significant drug acquisition costs. This review highlights the significant findings from the landmark clinical trials of trastuzumab for metastatic HER2-positive breast cancer, and the potential “value for money” associated with its use in clinical practice.

Hypofractionated Radiotherapy as Adjuvant Treatment in Early Breast Cancer. A Review and Meta-Analysis of Randomized Controlled Trials

“…Trastuzumab can be safely used after or concurrently with conventionally fractionated radiotherapy after breast-conserving surgery or mastectomy [32] at least if no radiotherapy for the treatment of the internal mammary chain lymph nodes is administered. In the palliative setting, trastuzumab was administered in combination with hypofractionated radiotherapy in different clinical situations [33,34,35]. No relevantly enhanced acute or late toxicity has been reported.…”

Towards Sustained Silencing of HER2/neu in Cancer By Epigenetic Editing

“…On the basis of these characteristics, Her2/neu is an attractive therapeutic target. The first U.S. Food and Drug Administration (FDA)-approved therapeutic to target Her2/neu in HER2-positive breast cancer is trastuzumab (7,8). Trastuzumab, a recombinant humanized monoclonal antibody, targets the extracellular domain of the Her2/neu receptor thereby inhibiting its dimerization and therefore its activation.…”

Adjuvante hypofraktionierte Strahlentherapie beim frühen Mammakarzinom. Übersicht und Meta-Analyse randomisierter kontrollierter Studien

“…Trastuzumab ist sicher für die Anwendung nach oder während einer konventionell fraktionierten Strahlentherapie nach brusterhaltender Operation oder Mastektomie [32], zumindest wenn keine Bestrahlung der Lymphknoten der Mammaria-interna-Kette durchgeführt wird. Im palliativen Setting ist Trastuzumab in Kombination mit hypofraktionierter Strahlentherapie in verschiedenen klinischen Situationen angewandt worden [33,34,35]. Hierbei wurde keine relevant erhöhte akute oder späte Toxizität beobachtet.…”