trastuzumab emtansine at a glance
Medicine class
HER2-targeted antibody–drug conjugate
Main use
Selected HER2-positive early, locally advanced or metastatic breast cancer
Administration
Intravenous infusion prepared and given by trained healthcare professionals
Key monitoring
Blood counts, liver function, heart function and symptoms of nerve or lung toxicity
What is trastuzumab emtansine used for?
UK-licensed uses in adults are:
Adjuvant treatment of HER2-positive early breast cancer when invasive disease remains in the breast or lymph nodes after pre-operative taxane-based and HER2-targeted therapy.
HER2-positive unresectable locally advanced or metastatic breast cancer previously treated with trastuzumab and a taxane, where advanced disease was previously treated or recurrence occurred within six months after adjuvant therapy.
How does trastuzumab emtansine work?
The trastuzumab component binds HER2 on cancer cells and can reduce HER2 signalling and recruit immune activity. The complex is taken into the cell and broken down, releasing DM1, which disrupts microtubules needed for cell division and promotes cancer-cell death.
trastuzumab emtansine preparations and strengths
Solution for infusion
Route: Intravenous
Strengths: 100 mg, 160 mg
How to take trastuzumab emtansine
Trastuzumab emtansine is not taken by mouth. It is reconstituted, diluted and given into a vein in a hospital or clinic, with observation for infusion reactions and monitoring of the infusion site.
It must not be given as an intravenous push or bolus.
Food does not affect administration because the medicine is given intravenously.
Tell staff immediately about pain, burning or tenderness around the infusion site.
Do not drive or use machinery while affected by dizziness, blurred vision, tiredness or an infusion reaction.
trastuzumab emtansine side effects
Common or expected effects
- Tiredness, nausea or vomiting
- Muscle or joint pain and headache
- Reduced platelets, anaemia or other blood-count changes
- Raised liver enzymes
- Nosebleeds or other bleeding
- Tingling, pain or numbness in the hands or feet
- Diarrhoea, constipation, abdominal discomfort or sore mouth
- Cough, breathlessness or fever
Get urgent medical advice
- Unexpected or persistent bleeding, extensive bruising or signs of severe thrombocytopenia
- New or worsening breathlessness or cough suggesting pneumonitis or interstitial lung disease
- Yellow skin or eyes, abdominal swelling or other signs of serious liver injury
- Breathlessness at rest, chest pain, swelling or an irregular heartbeat suggesting cardiac dysfunction
- Facial or tongue swelling, wheeze, difficulty breathing or swallowing, or a severe infusion reaction
- Pain, blistering, discolouration or skin breakdown at the infusion site
trastuzumab emtansine in pregnancy
Trastuzumab emtansine is not recommended during pregnancy because it may harm the fetus. Effective contraception is advised during treatment and for seven months afterwards; male patients or their female partners should also use effective contraception. A pregnancy during treatment requires immediate specialist review.
trastuzumab emtansine while breastfeeding
Breastfeeding should stop before treatment and should not restart until seven months after treatment has ended. It is unknown whether trastuzumab emtansine enters human milk, and serious effects in a breastfed infant are possible.
trastuzumab emtansine interactions
Provide the cancer team with a complete list of prescribed, over-the-counter and complementary products.
Strong CYP3A4 inhibitors, including itraconazole, ketoconazole, voriconazole, clarithromycin and ritonavir
These may increase exposure to DM1 and toxicity, so concurrent use should generally be avoided or managed with specialist monitoring.
Anticoagulants, such as warfarin, heparin or low-molecular-weight heparins
Bleeding risk may be increased, particularly if platelet counts fall; closer monitoring may be required.
Antiplatelet medicines, including aspirin
Concurrent use may add to bleeding risk and should be reviewed by the treating team.
Common questions about trastuzumab emtansine
Answers are fully visible for fast scanning and source review.
What is trastuzumab emtansine used for?
It treats specified HER2-positive early or advanced breast cancers in adults who meet the previous-treatment and disease-status requirements of its UK licence.
Is trastuzumab emtansine chemotherapy?
It is an antibody–drug conjugate: trastuzumab targets HER2, while the attached DM1 component is a cytotoxic microtubule inhibitor.
How is trastuzumab emtansine given?
A trained healthcare professional prepares it and gives it as an intravenous infusion in a hospital or clinic.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.