Breast cancer (early) - trastuzumab

Summary

Trastuzumab treatment should be offered as an option for women with early-stage HER2-positive breast cancer after they have had surgery and chemotherapy (and sometimes radiotherapy).

Trastuzumab should be given once every 3 weeks for 12 months, or until the breast cancer comes back, whichever is sooner.

Trastuzumab treatment has been associated with heart problems. Before trastuzumab is prescribed a woman should have tests to check how well her heart is working. The tests should be repeated every 3 months during treatment. If a woman develops heart problems while taking trastuzumab her treatment will be stopped.

Trastuzumab should not be offered to women with certain heart problems or with high blood pressure that is not well controlled with drugs or other treatment.

Correction

It has been brought to our attention that this guidance contained an error in section 1.3, where it stated that:

‘Cardiac functional assessments should be repeated every 3 months during trastuzumab treatment. If the LVEF drops by 10% from baseline and to below 50% then trastuzumab treatment should be suspended…’

This has now been amended so that it follows more closely the SPC for trastuzumab, as follows:

‘Cardiac functional assessments should be repeated every 3 months during trastuzumab treatment. If the LVEF drops by 10 percentage (ejection) points or more from baseline and to below 50% then trastuzumab treatment should be suspended…’

Electronic versions of the guidance have been amended below. Printed copies of the amended quick reference guide will be available shortly from the NHS Response Line; telephone 0870 1555 455 and quote reference number N1111.

Documents

For healthcare professionals

• TA107 Breast cancer (early) - trastuzumab: Guidance
• TA107 Breast cancer (early) - trastuzumab: Guidance (MS Word format)
• TA107 Breast cancer (early) - trastuzumab: Quick reference guide

For patients, carers and the public

• TA107 Breast cancer (early) - trastuzumab: Information for the public
• TA107 Breast cancer (early) - trastuzumab: Information for the public (MS Word format)
• TA107 Trastuzumab ar gyfer triniaeth gynorthwyol o ganser y fron HER2-positif cynnar

Background information

• Review Decision - November 2007
• Review Proposal September 2007: Appendix A
• Review Proposal September 2007
• 2006/038 NICE issues final guidance on trastuzumab

Implementing this guidance

Any further information NICE has produced to help the NHS implement this guideline locally is linked to below:

• TA107 Breast cancer (early) - trastuzumab: Audit criteria
• TA107 Breast cancer (early) - trastuzumab: Costing template and report