Injectable trastuzumab quicker than IV version

Share this content:

Subcutaneous administration of trastuzumab (Herceptin) appears to be as safe and effective as the much more time-consuming intravenous (IV) delivery system.

Patients with HER2-positive, clinical stage I–III breast cancer who receive trastuzumab, a monoclonal antibody that targets the HER2 protein, currently have to take the drug intravenously. This entails being connected to a drip for 90 minutes for the initial dose, and then for 30 minutes, usually once every 3 weeks, for subsequent doses. However, a new subcutaneous formulation of trastuzumab that takes approximately 5 minutes to administer appears to offer a valid treatment alternative.

In the randomized study designed to test injectable trastuzumab, 299 women with HER2-positive, operable, locally advanced, or inflammatory breast cancer were assigned to receive eight cycles of neoadjuvant chemotherapy administered concurrently with trastuzumab every 3 weeks intravenously (8 mg/kg loading dose, 6 mg/kg maintenance dose). Another 297 women received the same chemotherapy plus subcutaneous trastuzumab (fixed dose of 600 mg).

Pathological complete response was achieved in 40.7% of IV patients and 45.4% of subcutaneous users. The occurrence of grade 3 to 5 adverse events was similar between groups. The most common such event, neutropenia, was experienced by 33.2% of the IV group and 29% of the subcutaneous group, followed by leucopenia (5.7% and 4%, respectively) and febrile neutropenia (3.4% vs 5.7%, respectively).

However, a greater number of serious adverse events occurred in the subcutaneous group (62 of 297 patients [21%], compared with 37 of 298 patients [12%]), mainly due to infections and infestations in 8.1% of the subcutaneous group compared with 4.4% of the IV group. Of the three adverse events in the subcutaneous group that led to death (compared with one in the IV group), two were deemed to be treatment-related. All deaths occurred during the neoadjuvant phase.

Despite these incidents, the investigators concluded in The Lancet Oncology (2012;13[9]:869-878) that subcutaneously delivered trastuzumab offers a valid treatment alternative to IV administration.

You must be a registered member of ONA to post a comment.

Sign Up for Free e-newsletters

Regimen and Drug Listings


Bone Cancer Regimens Drugs
Brain Cancer Regimens Drugs
Breast Cancer Regimens Drugs
Endocrine Cancer Regimens Drugs
Gastrointestinal Cancer Regimens Drugs
Genitourinary Cancer Regimens Drugs
Gynecologic Cancer Regimens Drugs
Head and Neck Cancer Regimens Drugs
Hematologic Cancer Regimens Drugs
Lung Cancer Regimens Drugs
Other Cancers Regimens
Rare Cancers Regimens
Skin Cancer Regimens Drugs