Herceptin (Trastuzumab)

Herceptin (trastuzumab)




Herceptin is the brand name of a medicine called trastuzumab. It's used to treat some types of breast cancer, oesophageal cancer and stomach cancer.

How Herceptin works

Herceptin can help control the growth of cancer cells that contain high amounts of HER2 (human epidermal growth factor receptor 2).
HER2 is found in all human cells. It controls cell growth and repair.
But high levels of HER2 are found in some types of breast, oesophageal and stomach cancer, which helps the cancer cells grow and survive.
These are known as HER2 positive cancers. About one in five breast and stomach cancers are HER2 positive.
Herceptin works by blocking the effects of HER2 and encouraging the immune system (the body's natural defences) to attack and kill the cancer cells.

When Herceptin is used

Herceptin can be used to treat:
  • early HER2 positive breast cancer, following surgery and/or radiotherapy and chemotherapy, to reduce the risk of the cancer coming back
  • advanced HER2 positive breast cancer that has spread from the breast (metastatic breast cancer), to slow the growth of the cancer and increase survival time
  • advanced HER2 positive stomach cancer that has spread out of the stomach (metastatic stomach cancer)
  • advanced HER2 positive gastro-oesophageal cancer, affecting the area where the oesophagus (food pipe) meets the stomach
If you have breast, oesophageal or stomach cancer, tests will be carried out to check if your cancer is HER2 positive before Herceptin is offered.

How Herceptin is given

Herceptin is given during visits to a hospital or clinic.
It can be given in two ways:
  • by infusion – where the medication is fed slowly into your bloodstream through a drip; the first treatment usually takes about 90 minutes and further treatments take about 30 minutes
  • by subcutaneous injection – an injection under the skin of the thigh that takes a few minutes (this can only be used for breast cancer)
The first time you have Herceptin you'll need to stay in hospital for around six hours so you can be monitored for any side effects. Further treatment sessions usually only require up to two hours in hospital.
If you have breast cancer, you'll have treatment every one or three weeks. Stomach and oesophageal cancer is usually treated once every three weeks.
Early-stage breast cancer will require treatment for a year. For breast, oesophageal or stomach cancer that has spread, treatment is used for as long as it helps.

Side effects of Herceptin

Herceptin often causes side effects, although many of these will become less severe over time.
The following side effects affect around 1 in 10 people:
  • a reaction to the medication – this can cause chills, a high temperature, swelling of the face and lips, headache, hot flushes, feeling sick, wheezing and breathlessness
  • tiredness and difficulty sleeping (insomnia)
  • diarrhoea or constipation
  • a low number of infection-fighting white blood cells, which increases your risk of infections
  • loss of appetite and weight loss
  • pain in your muscles, joints, chest or tummy
  • a runny nose
  • sore, red eyes (conjunctivitis) or watery eyes
  • shaking (tremors)
  • dizziness
  • a cough
  • increased or decreased blood pressure
  • heart problems – you'll have regular tests to check for this (see below)
Your doctor or care team may be able to provide a full list of possible side effects. Visit Cancer Research UK for more information about the side effects of Herceptin.
Tell your doctor if you experience troublesome side effects, as there may be medicines available to treat them.

Heart monitoring on Herceptin

Heart problems can sometimes develop while you're on Herceptin and they can be serious.
Before treatment starts, you'll have a test to see how well your heart is working – for example, an ultrasound scan of your heart (echocardiogram) or a multi-gated acquisition (MUGA) scan.
Your heart will also be regularly checked during treatment.  
It's important to tell your doctor if you get any of the following symptoms of a heart problem while on Herceptin:
  • shortness of breath during the day or night
  • swollen ankles
If you develop a problem with your heart during treatment, it will usually improve if you have a short break from Herceptin.

Who may not be able to have Herceptin

Herceptin shouldn't be used to treat people with breast, oesophageal or stomach cancer that isn't HER2 positive.
It may also not be suitable if:
Avoid becoming pregnant while taking Herceptin and for at least seven months after treatment stops, as it could harm a developing baby.
Also avoid breastfeeding until at least seven months after treatment stops, as the medicine can get into breast milk and may be harmful for babies.

Reporting side effects

The Yellow Card Scheme allows you to report suspected side effects from any type of medicine you're taking.
The scheme is run by medicines safety watchdog, the Medicines and Healthcare products Regulatory Agency (MHRA).
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