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Herceptin
Clinical Pharmacology
Herceptin
Data from Study 5 suggest that the beneficial treatment effects were largely limited to patients with the highest level of HER2 protein overexpression (3+) (see Table 9).
Table 9: Treatment Effects in Study 5 as a Function of HER2
Overexpression or Amplification
| HER2 Assay Result | Number of Patients (N) | Relative Riskb for Time to Disease Progression (95% CI) | Relative Riskb for Mortality (95% CI) |
| CTA 2+ or 3+ | 469 | 0.49 (0.40, 0.61) | 0.80 (0.64, 1.00) |
| FISH (+)a | 325 | 0.44 (0.34, 0.57) | 0.70 (0.53, 0.91) |
| FISH (- )a | 126 | 0.62 (0.42, 0.94) | 1.06 (0.70, 1.63) |
| CTA 2+ | 120 | 0.76 (0.50, 1.15) | 1.26 (0.82, 1.94) |
| FISH (+) | 32 | 0.54 (0.21, 1.35) | 1.31 (0.53, 3.27) |
| FISH (- ) | 83 | 0.77 (0.48, 1.25) | 1.11 (0.68, 1.82) |
| CTA 3+ | 349 | 0.42 (0.33, 0.54) | 0.70 (0.51, 0.90) |
| FISH (+) | 293 | 0.42 (0.32, 0.55) | 0.67 (0.51, 0.89) |
| FISH (- ) | 43 | 0.43 (0.20, 0.94) | 0.88 (0.39, 1.98) |
| aFISH testing results were available for 451 of
the 469 patients enrolled on study. bThe relative risk represents the risk of progression or death in the Herceptin plus chemotherapy arm versus the chemotherapy arm. |
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Previously Treated Metastatic Breast Cancer (Study 6)
Herceptin was studied as a single agent in a multicenter, open-label, single-arm clinical trial (Study 6) in patients with HER2 overexpressing metastatic breast cancer who had relapsed following one or two prior chemotherapy regimens for metastatic disease. Of 222 patients enrolled, 66% had received prior adjuvant chemotherapy, 68% had received two prior chemotherapy regimens for metastatic disease, and 25% had received prior myeloablative treatment with hematopoietic rescue. Patients were treated with a loading dose of 4 mg/kg IV followed by weekly doses of Herceptin at 2 mg/kg IV.
The ORR (complete response + partial response), as determined by an independent Response Evaluation Committee, was 14%, with a 2% complete response rate and a 12% partial response rate. Complete responses were observed only in patients with disease limited to skin and lymph nodes. The overall response rate in patients whose tumors tested as CTA 3+ was 18% while in those that tested as CTA 2+, it was 6%.
Generic Name: Trastuzumab
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