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Trazimera (trastuzumab-qyyp)
trastuzumab
Black Box Warnings .
Cardiomyopathy
subclinical and clinical cardiac failure can occur; incidence and severity highest in combo w/ anthracyclines; evaluate left ventricular fxn prior to and during tx; if clinically significant decr. left ventricular fxn, D/C tx in pts receiving adjuvant tx and withhold tx in pts w/ metastatic breast CA
Infusion Rxns and Pulmonary Toxicity
can result in serious and fatal cases; s/sx occur during or w/in 24h of admin. of trastuzumab products in most cases; interrupt infusion if dyspnea or clinically significant hypotension, monitor pts until s/sx resolve completely; D/C tx if anaphylaxis, angioedema, interstitial pneumonitis, or ARDS
Embryo-Fetal Toxicity
exposure during pregnancy or w/in 7mo prior to conception can result in embryo-fetal death and birth defects, incl. oligohydramnios and oligohydramnios sequence manifesting as pulmonary hypoplasia, skeletal abnormalities, and neonatal death; advise pts of risks and need for effective contraception
Adult Dosing .
Dosage forms: INJ
Special Note
- [formulation clarification]
- Info: nonproprietary name = trastuzumab-qyyp; not interchangeable w/ ado-trastuzumab emtansine, fam-trastuzumab deruxtecan, SC trastuzumab/hyaluronidase, or SC pertuzumab/trastuzumab/hyaluronidase
- [uses, dosing may vary]
- Info: refer to institution protocols and pkg insert prior to prescribing for uses and dosing incl. toxicity-related dose adjustments
HER2-positive breast CA, adjuvant tx
- [combo w/ docetaxel or paclitaxel]
- Dose: 4 mg/kg/dose IV x1 on wk 1, then 2 mg/kg/dose IV qwk on wk 2-12, then 6 mg/kg/dose IV q3wk on wk 13-52; Info: use w/ docetaxel or paclitaxel on wk 1-12
- [combo w/ carboplatin and docetaxel]
- Dose: 4 mg/kg/dose IV x1 on wk 1, then 2 mg/kg/dose IV qwk on wk 2-18, then 6 mg/kg/dose IV q3wk on wk 19-52; Info: use w/ carboplatin and docetaxel on wk 1-18
- [monotherapy following anthracycline-based regimen]
- Dose: 8 mg/kg/dose IV x1 on day 1 of 21-day cycle for cycle 1, then 6 mg/kg/dose IV x1 on day 1 of 21-day cycle for cycles 2-17
HER2-positive breast CA, metastatic
- [combo w/ paclitaxel]
- Dose: 2 mg/kg/dose IV qwk, starting wk 2; Start: 4 mg/kg/dose IV x1 on wk 1
- [monotherapy]
- Dose: 2 mg/kg/dose IV qwk, starting wk 2; Start: 4 mg/kg/dose IV x1 on wk 1; Info: for recurrent dz
- [combo w/ pertuzumab (off-label)]
- Dose: 6 mg/kg/dose IV x1 on day 1 of 21-day cycle, starting cycle 2; Start: 8 mg/kg/dose IV x1 on day 1 of 21-day cycle for cycle 1
HER2-positive gastric CA, metastatic
- [6 mg/kg/dose IV x1 on day 1 of 21-day cycle, starting cycle 2]
- Start: 8 mg/kg/dose IV x1 on day 1 of 21-day cycle for cycle 1; Info: for pts w/ gastric or gastroesophageal junction adenocarcinoma; part of multi-drug chemo regimen
HER2-positive, RAS wild-type colorectal CA, unresectable or metastatic (off-label)
- [6 mg/kg/dose IV x1 on day 1 of 21-day cycle, starting cycle 2]
- Start: 8 mg/kg/dose IV x1 on day 1 of 21-day cycle for cycle 1; Info: give w/ tucatinib
renal dosing
- [see below]
- CrCl >30: no adjustment; CrCl <30: not defined
- HD/PD: not defined
hepatic dosing
- [not defined]
Peds Dosing .
Peds dosing is currently unavailable or not applicable for this drug.