Trastuzumab, monoclonal antibody
Thursday, 7 February 2013
Trastuzumab (INN; trade names Herclon, Herceptin) is a monoclonal antibody that interferes with the HER2/neu receptor. Its main use is to treat certain breast cancers.
The HER receptors are proteins that are embedded in the cell membrane and communicate molecular signals from outside the cell (molecules called EGFs) to inside the cell, and turn genes on and off. The HER proteins stimulate cell proliferation. In some cancers, notably certain types of breast cancer, HER2 is over-expressed, and causes cancer cells to reproduce uncontrollably.[1]
The original studies of trastuzumab showed that it improved overall survival in late-stage (metastatic) breast cancer from 20.3 to 25.1 months,[1] but there is controversy over whether trastuzumab is effective in earlier stage cancer.[2]Trastuzumab is also controversial because of its cost, as much as $100,000 per year,[3] and while certain private insurance companies in the U.S. and government health care systems in Canada, England and elsewhere have refused to pay for trastuzumab for certain patients, some companies have since accepted trastuzumab treatment as a covered preventative treatment.[4]
Trastuzumab is also being studied for the treatment of other cancers.[5] It has been used with some success in women with uterine papillary serous carcinomas that overexpress HER2/neu.[6]
References
- Hudis, CA (2007). “Trastuzumab–mechanism of action and use in clinical practice”. N Engl J Med. 357 (1): 39–51.doi:10.1056/NEJMra043186. PMID 17611206. Jul 5;357(1):39-51. Review /article
- 129 Herceptin and early breast cancer: a moment for caution [Editorial]. Lancet 2005;366:1673.
- “Herceptin or Trastuzumab: Efficacy, Side Effects”. Health and Life.
- “At last, Axa pays for Herceptin”. 2006.
- Vecchione L. Novel investigational drugs for gastric cancer.Expert Opin Investig Drugs. 2009 May 26. [Epub ahead of publication]. Review /article.
- Santin AD, Bellone S, Roman JJ, McKenney JK, Pecorelli S. (2008). “Trastuzumab treatment in patients with advanced or recurrent endometrial carcinoma overexpressing HER2/neu”.Int J Gynaecol Obstet 102 (2): 128–31.doi:10.1016/j.ijgo.2008.04.008. PMID 18555254.