The introduction of herceptin (Trastuzumab) into clinical practice for the treatment of breast cancer marks a major advance in the use of monoclonal antibody cancer therapy. Herceptin is a humanized antibody directed against the HER-2 antigen that is overexpressed on the tumor cell surface in approximately 25% of breast cancer patients. HER-2/neu/erbB2 overexpression marks an aggressive estrogen receptor-negative form of breast cancer. Therefore, a therapeutic agent selective for this target is particularly valuable. Herceptin is administered by intravenous infusion and in conjunction with paclitaxel can extend survival in patients with HER-2/neu/erbB2 overexpressing meta-static breast cancer. Herceptin use is associated with infusion- related hypotension, flushing and bronchocon-striction, and skin rash but no bone marrow toxicity. Herceptin appears to sensitize patients to cardiotoxic-ity, an important concern in patients also receiving doxorubicin.
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