ADO-TRASTUZUMAB EMTANSINE

Background and Date of Approval

Ado-trastuzumab emtansine is a prescription medication containing the active ingredient ado-trastuzumab emtansine. It is used to treat HER2-positive breast cancer that has spread to other parts of the body or has not responded to other treatments. This medication combines two drugs: trastuzumab, an antibody that targets HER2 receptors, and emtansine, a chemotherapy drug that kills cancer cells. It is indicated for the treatment of breast cancer in early stages as well as advanced stages where patients develop recurrence within six months of chemotherapy treatment. This medication acts against tumours that produce more than the normal amount of a certain protein known as HER2 protein. Ado-trastuzumab emtansine was approved by the United States Food and Drug Administration on 22 February 2013 for the treatment of HER2-positive metastatic breast cancer that has progressed despite prior treatment with other HER2-targeted therapies and chemotherapy. Since then, it has also been approved for use in the adjuvant post-surgical treatment of HER2-positive early-stage breast cancer.

Uses

Ado-Trastuzumab Emtansine is used for treating a specific type of breast cancer known as HER2-positive breast cancer. It is also used in the post-surgical treatment of HER2-positive early-stage breast cancer and may be used in combination with other treatments.

How is it administered?

Ado-Trastuzumab Emtansine is administered by a healthcare professional in a hospital or clinic setting. The dose and frequency depend on several factors, such as the individual's age, weight, overall health, and the type and stage of the cancer being treated. If a dose is missed, it should be taken as soon as possible unless it's almost time for the next scheduled dose, in which case the missed dose should be skipped, and the regular dosing schedule resumed. Do not double the dose to make up for missed doses. It is available in 100mg and 160mg strength.

Side Effects

Ado-trastuzumab emtansine is associated with several potential side effects. Common side effects include fatigue, nausea, muscle and joint pain, headache, and low red and white blood cell counts. More serious side effects may occur, such as liver toxicity, lung toxicity, heart problems, and bleeding disorders. In rare cases, it may cause serious and potentially life-threatening allergic reactions, including anaphylaxis. It is important to seek immediate medical attention if you experience any signs of an allergic reaction or other serious side effects.

Warnings

Ado-trastuzumab emtansine may cause heart problems, including heart failure or abnormal heart rhythms. Sometimes this medication may cause infusion reactions, including fever, chills, rash, or difficulty breathing. This drug can increase the risk of bleeding, including severe bleeding. In some cases, it may cause nerve damage, including numbness, tingling, or weakness. It may also cause low platelet counts, which can increase the risk of bleeding. In rare cases, this medication causes the rapid breakdown of cancer cells, which can release large amounts of substances into the bloodstream. This can cause kidney damage, electrolyte imbalances, and other complications. Patients with a high tumor burden may be at increased risk for tumor lysis syndrome. Patients taking this drug are at increased risk of infections, including severe infections.

Precautions

Several precautions should be taken when using Ado-Trastuzumab Emtansine. First, this medication should not be used in patients who are allergic to it or any of its components. Patients with pre-existing nerve damage or other conditions that affect nerve function may be at increased risk for nerve damage, and caution should be taken when using this medication in these patients. Patients with pre-existing heart conditions or risk factors for heart disease should be closely monitored during treatment. As this medication increases the risk of infections, including severe infections. You should avoid contact with people who have contagious illnesses and report any signs of infection to their healthcare provider promptly. You require close monitoring during and after the infusions for any signs of an infusion reaction. Patients should be carefully monitored for any signs of infection, bleeding, or anemia. Adjustments to the treatment regimen may be necessary to manage side effects and ensure the best possible outcomes.

Word of Advice

If you are receiving Ado-Trastuzumab Emtansine, it's important to be proactive in managing your treatment and monitoring your symptoms. Keep communication with your healthcare provider and report any concerns or side effects as soon as possible. Avoid getting pregnant and breastfeeding during treatment. Use effective birth control during the treatment and at least 7 weeks after the last dose. Immediately contact your healthcare provider in case of any worsening of symptoms or infusion reactions. Take steps to care for yourself physically and emotionally during treatment, and seek support from loved ones and professionals as needed. Maintain a healthy and balanced diet during treatment to support your overall health and well-being. Being informed and engaged in your treatment can help ensure the best possible outcomes and manage potential risks or complications.

References

Roche Products Limited, Electronic Medicines Compendium (EMC), [Revised on Jul 2021] [Accessed on 9th April 2023], https://www.medicines.org.uk/emc/files/pil.5252.pdf Gunter von Minckwitz et al., Trastuzumab Emtansine for Residual Invasive HER2-Positive Breast Cancer, N Engl J Med 2019; 380:617-628 [Accessed on 19th April 2023], https://www.nejm.org/doi/full/10.1056/NEJMoa1814017 Barok et al., Trastuzumab emtansine: mechanisms of action and drug resistance, Breast Cancer Research 2014, 16:209, [Accessed on 19th April 2023], https://www.researchgate.net/publication/262780064_Trastuzumab_emtansine_Mechanisms_of_action_and_drug_resistance Genentech, Inc. U.S Food and Drug Administration (FDA) [Last Revised 3rd May 2019], [Accessed on 19 April 2023], https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/125427s105lbl.pdf

Frequently Asked Questions

Can Ado-Trastuzumab Emtansine cause nerve damage?

Ado-Trastuzumab Emtansine can cause peripheral neuropathy, a type of nerve damage that can cause tingling, numbness, or weakness in the hands and feet. If you experience these symptoms during treatment, discuss them with your healthcare provider.

Does Ado-Trastuzumab Emtansine cause infertility?

Ado-Trastuzumab Emtansine can cause temporary infertility in some patients, particularly women. If fertility preservation is a concern for you, discuss this with your healthcare provider before starting treatment.

How is Ado-Trastuzumab Emtansine different from traditional chemotherapy?

Ado-Trastuzumab Emtansine is a type of chemotherapy, but it is designed to target HER2-positive cancer cells specifically, which may result in fewer side effects than traditional chemotherapy. Additionally, it is given as a single medication, rather than as a combination of drugs.

Can Ado-Trastuzumab Emtansine be used in combination with other cancer treatments?

Ado-Trastuzumab Emtansine may be used in combination with other cancer treatments, such as chemotherapy or targeted therapies. Your healthcare provider can help determine the best treatment plan for you based on your individual needs and medical history.

Can I take ado-trastuzumab emtansine if I have tuberculosis?

The use of ado-trastuzumab emtansine in patients with active tuberculosis (TB) is not recommended due to the risk of worsening the TB infection. This medication can suppress the immune system, making it harder for the body to fight off infections such as TB. Before starting treatment, your healthcare provider will perform a thorough evaluation of your medical history, including screening for TB.

Can Ado-Trastuzumab Emtansine cause heart problems?

Ado-Trastuzumab Emtansine can cause heart problems, particularly in patients with preexisting heart conditions or risk factors. Your healthcare provider will monitor your heart function closely during the treatment.

Available Brands 2

Written By: P. Thirumal Reddy

Reviewed By: Dr. Tejashwin Adiga