Use of Trastuzumab and an Anthracycline-Containing Regimen
➤ The administration of trastuzumab concurrently with the anthracycline
component of a chemotherapy regimen is not recommended because of the
potential for increased cardiotoxicity.
Concurrent Administration of Adjuvant Trastuzumab and
Non-Anthracycline Chemotherapy Regimens
➤ Trastuzumab should be preferentially administered concurrently (not
sequentially) with a non-anthracycline chemotherapy regimen.
Trastuzumab-Based Chemotherapy or Trastuzumab Regimens
For Patients at Higher Risk of Cardiotoxicity
➤ Less cardiotoxicity is seen with docetaxel-carboplatin-trastuzumab than with
doxorubicin-cyclophosphamide → docetaxel-trastuzumab, and docetaxel-
carboplatin-trastuzumab is recommended for patients at higher risk for
cardiotoxicity.*
Addition of Trastuzumab to Chemotherapy Regimens Not
Evaluated in a Phase III Trial
➤ No phase III evidence exists for the addition of trastuzumab to some
chemotherapy regimens, such as docetaxel-cyclophosphamide. However,
those regimens might be in use and are reasonable options, particularly for
mitigating cardiotoxicity in certain patients.*
Duration of Trastuzumab Therapy and Cardiac Function
➤ Patients should be offered 1 year total of adjuvant trastuzumab with regular
assessments of cardiac function during that period.*
