Is Kadcyla Right For You
Kadcyla can work in people diagnosed with HER2-positive metastatic breast cancer that has previously been treated with Herceptin and taxane chemotherapy.
Metastatic breast cancer is breast cancer that has spread to other parts of the body away from the breast, such as the bones or liver.
Kadcyla also can work after surgery in peoplediagnosed with early-stage HER2-positive breast cancer that was treated withHerceptin and taxane chemotherapy before surgery and had residual disease foundduring surgery.
Doctors call treatments given after surgeryadjuvant treatments. Doctors call treatments given before surgery neoadjuvanttreatments.
One way doctors judge the effectiveness ofneoadjuvant chemotherapy is to look at the tissue removed during surgery to seeif any actively growing cancer cells are present. If no active cancer cells arepresent, doctors call it a pathologic complete response or pCR. If there are cancercells present in the tissue removed, this cancer is called residual disease.
There are several tests used to find out if breast cancer is HER2-positive. To have been previously treated with Herceptin, one or more of these tests was used to figure out if the cancer was likely to respond. Two of the most common tests are:
If the IHC test results are borderline, its likely that a FISH test will be done on a sample of the cancer tissue to determine if the cancer is HER2-positive.
FISH
Hair Loss Thinning And Cancer Treatment
Hair loss or thinning is a common side effect of some cancer treatments.
It’s quite common to have hair loss or thinning with some chemotherapy drugs. Hormone therapy, targeted cancer drugs and immunotherapy are more likely to cause hair thinning. But some people might have hair loss.
Radiotherapy makes the hair fall out in the area being treated. Hair on other parts of the body is not usually affected.
Hormone Therapy For Premenopausal Women
For premenopausal women with metastatic breast cancer, hormone therapy almost always begins with ovarian suppression and either an aromatase inhibitor, tamoxifen or other hormone therapy drug.
Ovarian suppression lowers hormone levels in the body so the tumor cant get the estrogen it needs to grow. This may involve surgery to remove the ovaries or, more often, drugs to stop the ovaries from producing hormones.
Combining ovarian suppression and a hormone therapy drug improves survival over either treatment alone .
If breast cancer progressed during past treatment with a hormone therapy drug, the same hormone therapy drug may not be an option for treatment.
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What Is Trastuzumab Emtansine
Trastuzumab emtansine is a targeted therapy. Its generic is trastuzumab emtansine. You may hear it called Kadcyla, its brand name, or TDM1, its chemical name.
Trastuzumab emtansine is a combination of two drugs:
- Trastuzumab , which belongs to a group of drugs called targeted therapies. Targeted therapies block the growth and spread of cancer. They target and interfere with processes in the cells that help cancer grow
- Emtansine, which is a chemotherapy drug
Will My Hair Fall Out All At Once
Not everyone who has treatment for lymphoma experiences hair loss. If you do, your hair usually begins to fall out within a couple of weeks of starting treatment. It usually starts at the top and sides of your head, above your ears. It might fall out gradually, in clumps, or quite quickly. You might notice hair on your pillow or clothes, in your hairbrush, or in the plug hole of your bath or shower. Speak to your medical team for information about what to expect based on the treatment you are having.
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What Is The Most Important Safety Information I Should Know About Kadcyla
Liver problems
- KADCYLA may cause severe liver problems that can be life-threatening. Symptoms of liver problems may include vomiting, nausea, eating disorder , yellowing of the skin , stomach pain, dark urine, or itching
Heart problems
- KADCYLA may cause heart problems, including those without symptoms and those with symptoms . Symptoms may include swelling of the ankles or legs, shortness of breath, cough, rapid weight gain of more than 5 pounds in 24 hours, dizziness or loss of consciousness, or irregular heartbeat
Pregnancy
- Receiving KADCYLA during pregnancy can result in the death of an unborn baby and birth defects. Birth control should be used while you receive KADCYLA and for 7 months after your last dose of KADCYLA
- If you think you may be pregnant, you should contact your healthcare provider immediately
- If you are exposed to KADCYLA during pregnancy or if you become pregnant within 7 months following your last dose of KADCYLA, you are encouraged to report KADCYLA exposure to Genentech by calling
- If you are a male patient with a female partner that could become pregnant, birth control should be used during treatment and for 4 months following your last dose of KADCYLA
- You should not breastfeed during treatment and for 7 months after the last dose of KADCYLA
Contact your doctor right away if you experience symptoms associated with these side effects.
Is Kadcyla A Chemotherapy Drug
Yes and no. Kadcyla contains emtansine thats been chemically linked to ado-trastuzumab .
Monoclonal antibodies are not chemotherapy drugs. Theyre designed to be targeted therapies. So, Kadcyla is considered to be a targeted therapy.
Chemotherapy drugs work by killing all cells in your body that multiply and grow rapidly. This includes both cancer cells and noncancerous cells. As a result, chemotherapy drugs often cause side effects, such as vomiting and hair loss.
Kadcyla is different than chemotherapy because its designed to attach to specific targets on HER2-positive cancer cells.* Kadcyla typically causes less harm to healthy cells. However, mild or serious side effects are still possible.
If you have questions about Kadcyla or chemotherapy drugs, talk with your doctor.
* For more information about this condition, see the Kadcyla uses section below.
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Chemotherapy And Hair Loss
Hair loss is quite common in people who are treated with chemotherapy overall, around 2 in 3 people experience hair loss.
Chemotherapy kills lymphoma cells, but it can also destroy healthy cells, particularly those that normally divide quickly.
Hair follicles produce hair. They are among the fastest dividing cells in your body, which is why chemotherapy often affects them.
The nails on your fingers and toes might also be affected by chemotherapy. This is because nails contain keratin . Nails grow quickly, making them sensitive to chemotherapy. While youre having treatment, your nails might become dry, marked or discoloured and break easily.
Your medical team will speak to you about the likelihood of hair loss before you begin treatment. As a general guide:
- Chemotherapy regimens using more than one drug are more likely to cause hair loss than treatment with just one drug. Those that are given every 2 to 3 weeks are generally regimens that are more likely to cause hair loss than regimens given every week. If you experience hair loss, its likely to happen by the end of the second cycle.
- High-dose, intravenous chemotherapy is more likely to cause hair loss than low-dose chemotherapy taken as tablets or capsules . Conditioning treatment before a stem cell transplant usually involves high-dose chemotherapy. It can cause quick and complete hair loss, on areas of the body other than just your head.
Hair usually grows back within a few months to a year.
How To Take Exemestane
Exemestane comes as a tablet to take by mouth. The tablet should be taken once a day after a meal. Take exemestane at around the same time every day.
Do not take your medication with a high-fat meal, as this can increase the medication levels in your blood. The blood levels of this medication can also be affected by certain medications. These include: medications with estrogen including birth control pills or patches and hormone replacement therapy, rifampin, carbamazepine, phenobarbital, phenytoin, and St. Johns wort. Be sure to tell your healthcare provider about all medications and supplements you take. Your blood level of Vitamin D will be checked prior to starting this medication. If your Vitamin D level is low, you may require a supplement.
It is important to make sure you are taking the correct amount of medication every time. Before every dose, check that what you are taking matches what you have been prescribed.
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Does Herceptin Cause Hair Loss
Yes, its possible that Herceptin or Herceptin Hylecta can cause hair loss. How often this occurs in clinical studies varies, but in one study, up to 63% of people who took Herceptin or Herceptin Hylecta reported hair loss. However, many of the studies include other cancer treatments that can cause hair loss. This makes it hard to know if Herceptin or Herceptin Hylecta use caused the hair loss.
Talk with your doctor if youre concerned about how the medications youre taking may affect your hair.
Who Is Kadcyla For
Early Breast Cancer
KADCYLA is a prescription medicine used as an adjuvant treatment for HER2-positive early breast cancer when the patient has taken neoadjuvant treatment including a taxane and trastuzumab and there is cancer remaining in the tissue removed during surgery.
Patients are selected for therapy based on an FDA-approved test for KADCYLA.
Metastatic Breast Cancer
KADCYLA is a prescription medicine used to treat HER2-positive breast cancer that has spread to other parts of the body after prior treatment with trastuzumab and a taxane. Prior treatment could have been for the initial treatment of breast cancer or for the treatment of cancer that had spread to other parts of the body.
Patients are selected for therapy based on an FDA-approved test for KADCYLA.
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Phase 3 Study Findings Show The Importance Of T
In an interview with Targeted Oncology, Julie R. Gralow, MD, discussed the findings from the KAITLIN study of T-DM1 in early-stage breast cancer.
Over the last several years, there have been a plethora of new HER2 targeted agents that have been approved by the FDA. These therapies have made HER2-positive breast cancer highly survivable and highly curable, but unfortunately, some patients do still recur.
Among the many ongoing clinical trials evaluating the different treatment options in the HER2-positive setting, the KAITLIN study was recently presented at the 2020 American Society of Clinical Oncology Virtual Scientific Program. However, in the phase 3 KAITLIN study replacing adjuvant taxane therapy and trastuzumab with trastuzumab emtansine in combination with pertuzumab did not improve the overall survival in patients with HER2-positive breast cancer.
While the study failed to meet its primary end point, the T-DM1 appeared safe in this patient population. However, these findings may have helped demonstrate other patients in breast cancer who may benefit from T-DM1.
TARGETED ONCOLOGY: Can you discuss the current treatment landscape for HER2-positive early breast cancer and what does the prognosis generally look like for these patients?
TARGETED ONCOLOGY: What are the implications of these findings?
TARGETED ONCOLOGY: Are there any other next steps planned for this research?
TARGETED ONCOLOGY: Can you elaborate on the safety profile of T-DM1?
How Is Kadcyla Given
Like many cancer medicines, KADCYLA is given as an intravenous infusion in your doctors office, at a hospital, or at an infusion center. For HER2+ metastatic breast cancer, KADCYLA is given once every 3 weeks, until your disease is no longer controlled or your side effects require you to stop treatment.
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Tucatinib Neratinib And Lapatinib
The tyrosine-kinase inhibitors FDA-approved for metastatic breast cancer treatment are:
- Tucatinib
- Neratinib
- Lapatinib
Tyrosine-kinase inhibitors are a class of drugs that target enzymes important for cell functions . These drugs can block tyrosine-kinase enzymes at many points along the cancer growth pathway.
A tyrosine-kinase inhibitor in combination with trastuzumab and chemotherapy can be used to treat HER2-positive metastatic breast cancer. This combination may give women with HER2-positive metastatic breast cancer more time before the cancer spreads compared to treatment with trastuzumab and chemotherapy alone .
Adding the tyrosine-kinase inhibitor tucatinib to treatment with trastuzumab and chemotherapy may also increase overall survival in women with HER2-positive metastatic breast cancer who were treated with trastuzumab in the past .
Neratinib is also used to treat HER2-positive early breast cancer.
Tucatinib, neratinib and lapatinib are pills.
Learn about neratinib and treatment of early breast cancer.
Tucatinib, neratinib and lapatinib and brain metastases
Many drug therapies cannot pass through the blood to the brain . So, they cant treat breast cancer that has spread to the brain.
However, tucatinib, neratinib and lapatinib can pass through the blood-brain barrier and may be used to treat some metastatic breast cancers that have spread to the brain.
Pregnancy And Breastfeeding While Receiving Herceptin
Heres some information about pregnancy, breastfeeding, and Herceptin.
Pregnancy
Herceptin should not be used while pregnant and for at least 7 months after the last dose of the drug. Be sure to use birth control during this time. Herceptin may harm a fetus, and this could include pregnancy loss. In fact, Herceptin has a boxed warning about this risk. This is a serious warning from the FDA.
If you can become pregnant, your doctor will have you take a pregnancy test before you start receiving Herceptin. This is to make sure youre not pregnant when you start treatment.
The manufacturer of Herceptin, Genentech, has a pregnancy monitoring program to gather information on the use of the drug during pregnancy. If you become pregnant during your Herceptin treatment or within 7 months of your last dose, consider calling Genentech at 888-835-2555.
If youre pregnant or planning a pregnancy, talk with your doctor. They can suggest treatments other than Herceptin.
Breastfeeding
Its not known whether its safe to breastfeed while youre being treated with Herceptin. Its also not known whether the drug is present in human breast milk.
If youre breastfeeding or thinking about it, talk with your doctor. They can review the risks and benefits of Herceptin treatment and advise you on healthy feeding options for your child.
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Hormone Therapy For Postmenopausal Women
After menopause, hormone therapy for women with metastatic breast cancer can be an aromatase inhibitor, tamoxifen, fulvestrant or other hormone therapy drug.
If the first hormone therapy stops working and the cancer starts to grow again, a second hormone therapy can be used. If the second drug stops working, another can be tried.
Ovarian suppression isnt helpful for postmenopausal women because their ovaries have already stopped producing large amounts of estrogen.
When Not To Use Scalp Cooling
Scalp cooling is not suitable for use in all types of cancer or situations. You wont normally have scalp cooling if there is too high a risk that there might be cancer cells in your scalp blood vessels. This is because the cells in the scalp blood vessels might survive the treatment.
Scalp cooling is not recommended in people:
- with blood cancers such as leukaemia and lymphoma
- whose cancer has spread to the scalp
- who are due to have radiotherapy to their scalp
You would not have scalp cooling with continuous chemotherapy through a pump or with chemotherapy tablets. This is because you would have to wear the cold cap for 24 hours a day.
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