Subcutaneous Trastuzumab: A Review in HER2-Positive Breast Cancer
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Disclosure: The preparation of this review was not supported by any external funding.
Conflicts of interest: Young-A Heo and Yahiya Syed are salaried employees of Adis/Springer, are responsible for the article content and declare no relevant conflicts of interest.
Additional information about this Adis Drug Review can be found here
Abstract
A subcutaneous (SC) formulation of trastuzumab, a potent humanized anti-Human Epidermal growth factor Receptor 2 (HER2)
receptor monoclonal antibody, with a recombinant hyaluronidase (Herceptin Hylecta™; Herceptin®) is indicated in the USA
and EU for the treatment of HER2-positive breast cancer. In the phase III pivotal HannaH trial, SC trastuzumab was noninferior
to the standard intravenous (IV) formulation of trastuzumab with respect to trough drug concentrations and pathological complete response in patients with HER2-positive early breast cancer. Other clinical outcomes, including event-free survival and
overall survival rates, were generally similar between the formulation groups. SC trastuzumab had a manageable tolerability
profle in patients with HER2-positive early or metastatic breast cancer, with the safety profle being generally similar to that
of the IV formulation. In the phase III PrefHER and MetaspHER trials, more patients preferred SC over IV trastuzumab and
more healthcare professionals expressed satisfaction with the SC formulation. Relative to IV trastuzumab, SC trastuzumab
ofers a quicker and more convenient dosage regimen, thereby potentially improving patient convenience, providing economic
beneft and optimizing the use of medical resources. Thus, given the high preference for SC trastuzumab and its generally
similar efcacy and tolerability profle to that of the IV formulation, SC trastuzumab is the preferred treatment of choice in
patients receiving trastuzumab for the treatment of HER2-positive early or metastatic breast cancer.
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