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Systemic Anti-Cancer Therapy Regimen Library

BR Neoadjuvant/Adjuvant - trastuzumab Q3W

Treatment Overview

This regimen contains a biological anti-cancer medicine where one or more biosimilars may exist. These have been reviewed by the regulator (Medsafe) and by haematologists and/or oncologists nationally. Where haematologists and/or oncologists have agreed that there are no clinically significant differences in either safety or effectiveness between a biosimilar and originator product, these drugs may be used interchangeably. If a prescriber thinks there is a difference, then a specific brand will be named when prescribing.

Cycle 1 - 21 days - Loading Dose

Cycle length:
21

Cycles 2 to 17 - 21 days - Maintenance Dose

Cycle length:
21
If the initial loading dose of trastuzumab is well tolerated, subsequent doses may be administered over 30 minutes

Cycle details

Cycle 1 - 21 days - Loading Dose

Medication Dose Route Days Max Duration
trastuzumab 8 mg/kg intravenous 1 90 minutes

Cycles 2 to 17 - 21 days - Maintenance Dose

Medication Dose Route Days Max Duration
trastuzumab 6 mg/kg intravenous 1 90 minutes
If the initial loading dose of trastuzumab is well tolerated, subsequent doses may be administered over 30 minutes

Full details

Cycle 1 - 21 days - Loading Dose

Day: 1

Medication Dose Route Max duration Details
trastuzumab 8 mg/kg intravenous 90 minutes

Cycles 2 to 17 - 21 days - Maintenance Dose

Day: 1

Medication Dose Route Max duration Details
trastuzumab 6 mg/kg intravenous 90 minutes
Instructions:
If the initial loading dose of trastuzumab is well tolerated, subsequent doses may be administered over 30 minutes.

Supportive Care Factors

Factor Value
Emetogenicity: Minimal

References

1. Moja, L., L. Tagliabue, S. Balduzzi, et al. 2012. "Trastuzumab containing regimens for early breast cancer." Cochrane Database Syst Rev 4:CD006243, PMID: 22513938

2. Untch, M., S. Loibl, J. Bischoff, et al. 2012. "Lapatinib versus trastuzumab in combination with neoadjuvant anthracycline-taxane-based chemotherapy (GeparQuinto, GBG 44): a randomised phase 3 trial." Lancet Oncol 13(2):135-144., PMID: 22257523

3. Gianni, L., W. Eiermann, V. Semiglazov, et al. 2010. "Neoadjuvant chemotherapy with trastuzumab followed by adjuvant trastuzumab versus neoadjuvant chemotherapy alone, in patients with HER2-positive locally advanced breast cancer (the NOAH trial): a randomised controlled superiority trial with a parallel HER2-negative cohort." Lancet 375(9712):377-384., PMID: 20113825

4. Untch, M., M. Rezai, S. Loibl, et al. 2010. "Neoadjuvant treatment with trastuzumab in HER2-positive breast cancer: results from the GeparQuattro study." J Clin Oncol 28(12):2024-2031, PMID: 20308670

5. Valachis, A., D. Mauri, N. P. Polyzos, et al. 2011. "Trastuzumab combined to neoadjuvant chemotherapy in patients with HER2-positive breast cancer: a systematic review and meta-analysis." Breast 20(6):485-490., PMID: 21784637

6. Roche Products (New Zealand) Limited. Herceptin (trastuzumab) New Zealand Data Sheet. https://www.medsafe.govt.nz/profs/Datasheet/h/Herceptininf.pdf (Accessed 16 February 2021).

7. Tabernero J, Vyas M, Giuliani R, Arnold D, Cardoso F, Casali PG, Cervantes A, Eggermont AMM, Eniu A, Jassem J, Pentheroudakis G, Peters S, Rauh S, Zielinski CC, Stahel RA, Voest E, Douillard JY, McGregor K, Ciardiello F. Biosimilars: a position paper of the European Society for Medical Oncology, with particular reference to oncology prescribers. ESMO Open. 2017 Jan 16;1(6):e000142. doi: 10.1136/esmoopen-2016-000142. , PMID: 28848668

8. Lyman GH, Balaban E, Diaz M, Ferris A, Tsao A, Voest E, Zon R, Francisco M, Green S, Sherwood S, Harvey RD, Schilsky RL. American Society of Clinical Oncology Statement: Biosimilars in Oncology. J Clin Oncol. 2018 Apr 20;36(12):1260-1265. doi: 10.1200/JCO.2017.77.4893. Epub 2018 Feb 14. , PMID: 29443651

* The medicines, doses, combinations, and schedule in this treatment regimen have been carefully reviewed against international best practice guidelines by specialists in medical oncology around New Zealand and this advice has been accepted for publication by Te Aho o Te Kahu (the Cancer Control Agency). Sometimes medicines that are used in routine clinical practice have not been through a formal review process by the NZ Medicines Regulator Medsafe and are therefore considered unapproved or off-label. These medicines are legally able to be prescribed through sections 25 and 29 of the Medicines Act and by obtaining informed consent from patients. All treatment regimens listed on this website have been through robust peer review and are considered an accepted standard of care, whether prescribed through sections 25 or 29 or carrying formal Medsafe Approval.

s29: This symbol indicates that some formulations of the associated medicine are legally only able to be prescribed under section 29 of the Medicines Act. You can see which formulations are section 29 by hovering over the s29 symbol. You can access full medication details from the New Zealand Formulary by clicking on the medication name. Each clinician retains full responsibility for ensuring they have complied with all relevant obligations and requirements of section 29 including obtaining informed patient consent prior to prescribing the applicable medicine.