Trastuzumab

Trastuzumab (Herceptin, Tuznue) has 10 EU-approved indications in 2 tumour types. Each needs a biomarker result: HER2 (10).
Approved indications of Trastuzumab
Biomarker requirementRegimenSettingConditions
Breast cancer9
HER2 IHC 3+ or IHC 2+/ISH-positive
+ neoadjuvant chemotherapy
Neoadj.
Then adjuvant monotherapy after surgery; Locally advanced (including inflammatory) disease or tumours > 2 cm in diameter
HER2 IHC 3+ or IHC 2+/ISH-positive
+ docetaxel and carboplatin
Adj.
early
None
HER2 IHC 3+ or IHC 2+/ISH-positive
+ paclitaxel or docetaxel
Adj.
early
After adjuvant chemotherapy with doxorubicin and cyclophosphamide
HER2 IHC 3+ or IHC 2+/ISH-positive
Monotherapy
Adj.
early
Following surgery, chemotherapy (neoadjuvant or adjuvant) and radiotherapy (if applicable)
HER2 IHC 3+ or IHC 2+/ISH-positive
Monotherapy
Adj.
After neoadjuvant Herceptin + chemotherapy and surgical resection; Locally advanced (including inflammatory) disease or tumours > 2 cm in diameter
HER2 IHC 3+ or IHC 2+/ISH-positive
+ docetaxel
1L
metastatic
None
HER2 IHC 3+ or IHC 2+/ISH-positive
+ paclitaxel
1L
metastatic
Anthracycline is not suitable
HER2 IHC 3+ or IHC 2+/ISH-positive
Monotherapy
3L+
metastatic
After at least two prior chemotherapy regimens for metastatic disease including an anthracycline and a taxane (unless unsuitable); failed hormonal therapy for hormone receptor-positive disease (unless unsuitable)
HER2 IHC 3+ or IHC 2+/ISH-positive, HR-positive
+ aromatase inhibitor
Any line
metastatic
No prior trastuzumab; Postmenopausal
Gastric and GEJ adenocarcinoma1
HER2 IHC 3+ or IHC 2+/ISH-positive
+ capecitabine or 5-fluorouracil, and cisplatin
1L
metastatic
None
Full text of section 4.1 (therapeutic indications)
Tuznue

Breast cancer Metastatic breast cancer Tuznue is indicated for the treatment of adult patients with HER2 positive metastatic breast cancer (MBC): - as monotherapy for the treatment of those patients who have received at least two chemotherapy regimens for their metastatic disease. Prior chemotherapy must have included at least an anthracycline and a taxane unless patients are unsuitable for these treatments. Hormone receptor positive patients must also have failed hormonal therapy, unless patients are unsuitable for these treatments. - in combination with paclitaxel for the treatment of those patients who have not received chemotherapy for their metastatic disease and for whom an anthracycline is not suitable. - in combination with docetaxel for the treatment of those patients who have not received chemotherapy for their metastatic disease. - in combination with an aromatase inhibitor for the treatment of postmenopausal patients with hormone-receptor positive MBC, not previously treated with trastuzumab. Early breast cancer Tuznue is indicated for the treatment of adult patients with HER2 positive early breast cancer (EBC): - following surgery, chemotherapy (neoadjuvant or adjuvant) and radiotherapy (if applicable) (see section 5.1). - following adjuvant chemotherapy with doxorubicin and cyclophosphamide, in combination with paclitaxel or docetaxel. - in combination with adjuvant chemotherapy consisting of docetaxel and carboplatin. - in combination with neoadjuvant chemotherapy followed by adjuvant Tuznue therapy, for locally advanced (including inflammatory) disease or tumours > 2 cm in diameter (see sections 4.4. and 5.1). Tuznue should only be used in patients with metastatic or early breast cancer whose tumours have either HER2 overexpression or HER2 gene amplification as determined by an accurate and validated assay (see sections 4.4 and 5.1) Metastatic gastric cancer Tuznue in combination with capecitabine or 5-fluorouracil and cisplatin is indicated for the treatment of adult patients with HER2 positive metastatic adenocarcinoma of the stomach or gastro-esophageal junction who have not received prior anti-cancer treatment for their metastatic disease. Tuznue should only be used in patients with metastatic gastric cancer (MGC) whose tumours have HER2 overexpression as defined by IHC 2+ and a confirmatory SISH or FISH result, or by an IHC 3+ result. Accurate and validated assay methods should be used (see sections 4.4 and 5.1).

Herceptin

Breast cancer Metastatic breast cancer Herceptin is indicated for the treatment of adult patients with HER2 positive metastatic breast cancer: (MBC): - as monotherapy for the treatment of those patients who have received at least two chemotherapy regimens for their metastatic disease. Prior chemotherapy must have included at least an anthracycline and a taxane unless patients are unsuitable for these treatments. Hormone receptor positive patients must also have failed hormonal therapy, unless patients are unsuitable for these treatments. - in combination with paclitaxel for the treatment of those patients who have not received chemotherapy for their metastatic disease and for whom an anthracycline is not suitable. - in combination with docetaxel for the treatment of those patients who have not received chemotherapy for their metastatic disease. - in combination with an aromatase inhibitor for the treatment of postmenopausal patients with hormone-receptor positive MBC, not previously treated with trastuzumab. Early breast cancer Herceptin is indicated for the treatment of adult patients with HER2 positive early breast cancer. (EBC). - following surgery, chemotherapy (neoadjuvant or adjuvant) and radiotherapy (if applicable) (see section 5.1). - following adjuvant chemotherapy with doxorubicin and cyclophosphamide, in combination with paclitaxel or docetaxel. - in combination with adjuvant chemotherapy consisting of docetaxel and carboplatin. - in combination with neoadjuvant chemotherapy followed by adjuvant Herceptin therapy, for locally advanced (including inflammatory) disease or tumours > 2 cm in diameter (see sections 4.4 and 5.1). Herceptin should only be used in patients with metastatic or early breast cancer whose tumours have either HER2 overexpression or HER2 gene amplification as determined by an accurate and validated assay (see sections 4.4 and 5.1). Metastatic gastric cancer Herceptin in combination with capecitabine or 5-fluorouracil and cisplatin is indicated for the treatment of adult patients with HER2 positive metastatic adenocarcinoma of the stomach or gastro-esophageal junction who have not received prior anti-cancer treatment for their metastatic disease. Herceptin should only be used in patients with metastatic gastric cancer (MGC) whose tumours have HER2 overexpression as defined by IHC2+ and a confirmatory SISH or FISH result, or by an IHC 3+ result. Accurate and validated assay methods should be used (see sections 4.4 and 5.1). Herceptin is indicated for the treatment of adult patients with HER2 positive metastatic breast cancer (MBC): Herceptin is indicated for the treatment of adult patients with HER2 positive early breast cancer (EBC).

Label history

67 changes to the Herceptin label since 2002, 6 of them to the indications. Newest first, in the words of EMA's record of each procedure.

Product

Changes