Ado Trastuzumab emtansine Brand Name– Kadcyla
What is Ado Trastuzumab emtansine
Ado trastuzumab emtansine is a HER2-targeted antibody-drug conjugate (ADC) that contains the humanized anti-HER2 IgG1, trastuzumab, covalently linked to the microtubule inhibitory drug, DM1 (a derivative of maytansine) by a stable thioether linker MCC (4-[N-maleimidomethyl] cyclohexane-1-carboxylate).
Emtansine refers to the MCC-DM1 conjugate. It is indicated for the adjuvant treatment of patients with HER2-positive early breast cancer with residual invasive disease after neoadjuvant taxane and trastuzumab-based therapy, as well as for the treatment of patients with HER2-positive, metastatic breast cancer who have previously received trastuzumab and a taxane, either separately or in combination.
Before treatment with ado-trastuzumab emtansine, patients should have either received prior therapy for metastatic disease or developed disease recurrence during or within 6 months of completing adjuvant therapy.
Indications
- breast cancer
For the treatment of patients with HER2-positive breast cancer
Side Effects
- abdominal pain
- acute respiratory distress syndrome (ARDS)
- anaphylactoid reactions
- anemia
- antibody formation
- arthralgia
- asthenia
- back pain
- bleeding
- blurred vision
- bone pain
- bronchospasm
- cardiotoxicity
- chills
- cirrhosis
- conjunctivitis
- constipation
- cough
- cystitis
- diarrhea
- dizziness
- dysgeusia
- dyspnea
- elevated hepatic enzymes
- epistaxis
- erythema
- fatigue
- fever
- flushing
- GI bleeding
- headache
- heart failure
- hepatic encephalopathy
- hepatic failure
- hepatotoxicity
- hyperbilirubinemia
- hyperphosphatemia
- hypertension
- hyperuricemia
- hypokalemia
- hypotension
- infection
- infusion-related reactions
- injection site reaction
- insomnia
- interstitial lung disease
- intracranial bleeding
- lacrimation
- muscle cramps
- musculoskeletal pain
- myalgia
- nausea
- neutropenia
- paresthesias
- peripheral edema
- peripheral neuropathy
- pneumonitis
- pruritus
- rash
- renal failure (unspecified)
- sinus tachycardia
- skin irritation
- stomatitis
- teratogenesis
- thrombocytopenia
- tumor lysis syndrome (TLS)
- vomiting
- wheezing
- xerophthalmia
- xerostomia
Monitoring Parameters
- CBC with differential
- ejection fraction
- LFTs
- pregnancy testing
Contraindications
- angina
- anticoagulant therapy
- Asian patients
- bleeding
- breast-feeding
- cardiac arrhythmias
- cardiotoxicity
- contraception requirements
- ensure correct formulation selection
- extravasation
- heart failure
- hepatic disease
- hepatitis
- hepatotoxicity
- human anti-human antibody (HAHA)
- infertility
- infusion-related reactions
- male-mediated teratogenicity
- myocardial infarction
- peripheral neuropathy
- pneumonitis
- pregnancy
- pregnancy testing
- pulmonary disease
- radiation therapy
- reproductive risk
- respiratory distress syndrome
- respiratory insufficiency
- thrombocytopenia
- tumor lysis syndrome (TLS)
- ventricular dysfunction
Interactions
- Abciximab
- Acetaminophen; Aspirin, ASA; Caffeine
- Amoxicillin; Clarithromycin; Lansoprazole
- Amoxicillin; Clarithromycin; Omeprazole
- Anagrelide
- Anticoagulants
- Antithrombin III
- Apixaban
- Argatroban
- Aspirin, ASA
- Aspirin, ASA; Butalbital; Caffeine
- Aspirin, ASA; Butalbital; Caffeine; Codeine
- Aspirin, ASA; Caffeine; Dihydrocodeine
- Aspirin, ASA; Caffeine; Orphenadrine
- Aspirin, ASA; Carisoprodol
- Aspirin, ASA; Carisoprodol; Codeine
- Aspirin, ASA; Citric Acid; Sodium Bicarbonate
- Aspirin, ASA; Dipyridamole
- Aspirin, ASA; Omeprazole
- Aspirin, ASA; Oxycodone
- Aspirin, ASA; Pravastatin
- Atazanavir
- Atazanavir; Cobicistat
- Betrixaban
- Bivalirudin
- Boceprevir
- Ceritinib
- Chloramphenicol
- Cilostazol
- Ciprofloxacin
- Clarithromycin
- Clopidogrel
- Clozapine
- Cobicistat
- Conivaptan
- Dabigatran
- Dalteparin
- Danaparoid
- Darunavir
- Darunavir; Cobicistat
- Darunavir; Cobicistat; Emtricitabine; Tenofovir alafenamide
- Dasabuvir; Ombitasvir; Paritaprevir; Ritonavir
- Delavirdine
- Desirudin
- Dipyridamole
- Edoxaban
- Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Alafenamide
- Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Disoproxil Fumarate
- Enoxaparin
- Eptifibatide
- Fluvoxamine
- Fondaparinux
- Fosamprenavir
- grapefruit juice
- Heparin
- Idelalisib
- Indinavir
- Itraconazole
- Ketoconazole
- Lepirudin
- Letermovir
- Lopinavir; Ritonavir
- Mifepristone
- Nefazodone
- Nelfinavir
- Ombitasvir; Paritaprevir; Ritonavir
- Palifermin
- Penicillamine
- Pentosan
- Platelet Inhibitors
- Posaconazole
- Prasugrel
- Ribociclib
- Ribociclib; Letrozole
- Ritonavir
- Rivaroxaban
- Saquinavir
- Telaprevir
- Telithromycin
- Telotristat Ethyl
- Ticagrelor
- Ticlopidine
- Tinzaparin
- Tipranavir
- Tirofiban
- Tuberculin Purified Protein Derivative, PPD
- Tucatinib
- Vorapaxar
- Voriconazole
- Warfarin
