Trastuzumab is a monoclonal antibody that targets HER2-positive tumor cells and is commonly used in the treatment of HER2-positive breast and gastric cancer. Although its efficacy is remarkable, there are some important matters to be paid attention to in the process of use to ensure safety and efficacy.
1. Cardiac monitoring Trastuzumab can cause cardiac toxicity, including left ventricular dysfunction, arrhythmia, hypertension, heart failure and so on. Therefore, patients should have a baseline cardiac evaluation, including an electrocardiogram and echocardiogram, before starting treatment. Cardiac function should be monitored regularly during treatment, especially after the use of anthracyclines.
2. Infusion reactions Trastuzumab infusion may cause infusion reactions, such as chills, fever, flushing, itching or swelling of the skin. For mild to moderate infusion reactions, the infusion rate can be reduced; for severe reactions, the infusion should be interrupted in time and symptomatic treatment should be given.
3. Hematological monitoring Trastuzumab may cause hematological toxicity, such as decreased white blood cell count and thrombocytopenia. Therefore, the blood condition should be checked before the use of trastuzumab and reexamined regularly.
4. Renal function and liver function Before using trastuzumab, the patient’s liver function and renal function should be checked. Outbreaks of hepatitis may occur in patients with a previous history of hepatitis, so drugs that control the hepatitis virus should continue to be used during medication; concomitant use of drugs that are nephrotoxic should be avoided.
5. Medication for
special population
Pregnant women: Trastuzumab may be harmful to the fetus and should be avoided during pregnancy, and contraception should be used for 7 months after the end of treatment.
Breastfeeding women: Breastfeeding should be avoided during treatment.
Children: The safety and efficacy of trastuzumab in patients under 18 years of age have not been established.
Elderly: The elderly have a higher risk of cardiac insufficiency and should be used with extreme caution.
6. Drug interactions Trastuzumab should not be used in combination with anthracyclines (such as doxorubicin and epirubicin), which may cause fatal heart failure, death, mucous emboli and cerebral embolism.
7. Withdrawal and Permanent Withdrawal Trastuzumab should be permanently discontinued in patients with severe and life-threatening infusion reactions.
Trastuzumab
is an effective HER2 targeted therapy, but the medical supervision must be strictly followed in the use of trastuzumab, and the above matters should be paid attention to to ensure the safety and effectiveness of the treatment. Patients should keep close communication with doctors and report any adverse reactions in time so that doctors can adjust their treatment plans in time.
