An injectable form of Herceptin could substantially cut the time spent in hospital for some women undergoing breast cancer treatment, suggest the results of a Phase 3 trial published online in The Lancet Oncology.
Women with HER2-positive breast cancer, which accounts for one in five cases, are often treated with Herceptin (trastuzumab), alongside standard chemotherapy.
This has to be administered intravenously, requiring the patient to be hooked up to a drip for 90 minutes for their first dose. If the drug is well tolerated, the patient then needs to travel to hospital to receive subsequent doses, spending 30 minutes on a drip, usually once every 3 weeks.
The researchers found that an injectable formulation of the drug appears to be as effective as the traditional intravenous formulation, with the drug being used by the body in the same way, and similarly prompting the disappearance of all clinical evidence of the disease (pCR).
The different formulations were compared in 299 women randomly assigned to intravenous trastuzumab and 297 given the drug subcutaneously.
The authors caution that it is too soon to say if injectable trastuzumab results in comparable survival and reduction in deaths as the intravenous formulation, but previous studies suggest that pCR rates correlate with survival and a reduction in the death rate.
The injectable formulation also has a comparable safety profile, raising hopes that in future, treatment for women taking trastuzumab for breast cancer could become considerably less time consuming.
The new formulation may also offer the potential for use at home, after appropriate training and support, say the authors.
Study author Dr Gustavo Ismael of the Amaral Carvalho Hospital in Brazil, said the new formulation offered “a valid alternative” to existing intravenously delivered treatments.
“The shortened duration of administration with subcutaneous trastuzumab has the potential to save time for patients, physicians and nursing staff,” he suggested.
In a linked Comment, Javier Cortes of the Vall d´Hebron Institute of Oncology in Spain, highlights the potential advantages of delivering trastuzumab subcutaneously.
“The ability to deliver the drug in about 5 minutes without the need to secure intravenous access makes treatment more convenient,” he said.
“Once the drug can be administered at home, patients will be able to continue their lives with less hospital dependence, which is an important psychological aspect,” he added.