Herceptin (trastuzumab)

This section explains what Herceptin is, how it works, when it may be given, what the benefits are and what side effects may occur. Herceptin is the brand name of the drug, which is used throughout the section. Most people know it by this name, although its generic (non-branded) name is trastuzumab.

Page Contents

What is Herceptin?
How does it work?
Who might be offered Herceptin?
Can I be tested for HER2?
How is Herceptin given?
What are the side effects of Herceptin?
How long will I be on Herceptin?
Further Support
Help from Action Breast Cancer

What is Herceptin?

Until recently Herceptin was used to treat secondary breast cancer (cancer that has spread to other parts of the body). However, results of more recent clinical trials show that Herceptin is an effective treatment for early stage breast cancer. It belongs to a new group of drugs called monoclonal antibodies.
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How does it work?

Herceptin targets cancer cells that ‘overproduce’ or make too much of a substance called HER2. This protein is found on the surface of breast cancer cells. Herceptin slows or stops the growth of these cells.
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Who might be offered Herceptin?

Herceptin is only used to treat cancers that are HER2 positive. Approximately 20-30% of breast cancers overproduce HER2.
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Can I be tested for HER2?

Your tumour can be tested for HER2 status as part of routine diagnostic testing at all breast cancer disease stages. The test can be done on tissue stored at the hospital from your original diagnosis or a new biopsy can be taken.
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How is Herceptin given?

Herceptin is given as a drip into a vein in the arm or hand. You will have your treatment as an outpatient, usually once a week, although it can also be given once every three weeks. With weekly treatment, the first dose is given over 90 minutes. If you don’t have any side effects then further doses are given over 30 minutes. With three-weekly treatment, each dose is given over 90 minutes. You may be given Herceptin on its own or in combination with chemotherapy drugs.
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What are the side effects of Herceptin?

Everyone reacts differently to drugs. Some people may experience more side effects than others. As Herceptin only affects cancer cells it has fewer side effects than chemotherapy drugs that also affect healthy cells. If you are having both at the same time you may have other side effects from the chemotherapy that are not listed here. If you have any questions about side effects, talk to your breast care nurse or specialist.

Common side effects

Flu-like symptoms
You may have fever, chills and mild pain in some parts of your body shortly after the drug has been given. These are only temporary and can be helped with mild painkillers such as paracetomol.

Nausea
If you feel sick this is usually mild and temporary and can be treated effectively with anti-sickness drugs.

Diarrhoea
You may have mild diarrhoea but your specialist or GP can prescribe medicine to help control this.

Less common side effects.
You may have other symptoms after your first treatment, for example headache, dizziness, rash, vomiting or breathlessness. These symptoms are usually very mild and don’t usually recur with later treatments.

Rare side effects

Effects on the heart
A small number of people receiving Herceptin may develop heart problems such as low blood pressure or palpitations, although most of the symptoms can be treated successfully. Heart problems seem to be more common where Herceptin is given with certain chemotherapy drugs, particularly doxorubicin. This may be more of a risk in patients who are over 65.
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How long will I be on Herceptin?

The length of time Herceptin is given will vary from person to person and your specialist will talk to you about what is best for you. If you are being given Herceptin with chemotherapy or you are taking part in a clinical trial you may be on it for a specific length of time.
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Further Support

If you have any concerns about taking Herceptin you can talk to your specialist, chemotherapy nurse or breast care nurse. With a breast cancer diagnosis, there may be times when you feel overcome by fear, anxiety, sadness, depression or anger. You may be able to cope with these feelings on your own or with the support of those closest to you such as your family and friends. If you find you need extra support, you can talk to your oncology nurse or home care specialist nurse. A counsellor or psychotherapist may be more appropriate if you need more long-term professional help. The Irish Cancer Society funds a counselling service. A counsellor will provide emotional support by allowing you to express your feelings and fears. Counselling may help you to see things differently, and help you through a difficult patch. You may be able to express worries or concerns to a counsellor that you do not wish to discuss with others. For further information contact the National Cancer Helpline on 1800 20 700.
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ABC would like to thank Breast Cancer Care in the UK for their permission to adapt the text in this factsheet from their series of factsheets.