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Trastuzumab

 Trastuzumab is standard of care in the treatment of human epidermal growth factor receptor (HER)-2+ early and advanced breast cancer. Recently, it has been approved for the treatment of HER-2+ advanced gastric cancer. Trastuzumab is an IgG1 humanized monoclonal antibody administered by intravenous infusion on a weekly or three weekly schedule. In all registered indications, trastuzumab is almost always given in combination with chemotherapy. In hormonal receptor-positive breast cancer in postmenopausal women, trastuzumab can be combined with an aromatase inhibitor. Main toxicity is reduction in the left ventricular ejection fraction, which in a minority of patients can become symptomatic, but in many patients is at least partly reversible. Long-term safety needs to be further determined. Trastuzumab (Herceptin®; F. Hoffmann-La Roche, Basel, Switzerland) is registered for the treatment of human epidermal growth factor receptor (HER)-2+ metastatic breast cancer, for adjuvant treatment of localized HER-2+ breast cancer, and for HER-2+ metastatic adenocarcinoma of the stomach or gastroesophageal junction. In the U.S. and European Union (EU), trastuzumab is indicated for breast cancer patients with a proven amplification of the HER-2 oncogene or overexpression of the HER-2 protein in the tumor. Overexpression of HER-2 or amplification of HER-2 is associated with adverse disease prognosis and shorter overall and disease-free survival times