What are the indications, pharmacology, side effects, administration, and dose modification of the following drugs used in targeted therapy against cancer: Trastuzumab, Pertuzumab, and Bevacizumab?
Indications
Pharmacology
Side effects
Administration
Dose modification
Trastuzumab is indicated for the treatment of breast cancer that is HER2-positive, and it is a monoclonal antibody that binds to the extracellular domain of HER2, inhibiting its signaling.
Pertuzumab is indicated for the treatment of HER2-positive breast cancer in the neoadjuvant and metastatic settings, and it is a humanized monoclonal antibody that targets the extracellular dimerization domain of HER2/neu, inhibiting its signaling.
Bevacizumab is indicated for the treatment of metastatic colorectal cancer, non-small cell lung cancer, glioblastoma, and metastatic renal cell carcinoma, and it is a monoclonal antibody that binds to VEGF, inhibiting angiogenesis.
The most common side effects of trastuzumab are fatigue, headache, fever, chills, nausea, vomiting, diarrhea, and infusion reactions.
The most common side effects of pertuzumab are fatigue, headache, fever, dizziness, rash, diarrhea, stomatitis, and neutropenia.
The most common side effects of bevacizumab are fatigue, headache, hypertension, bleeding, thromboembolism, gastrointestinal perforation, and impaired wound healing.
Trastuzumab is administered intravenously, and the recommended dose is an initial loading dose of 4 mg/kg followed by a maintenance dose of 2 mg/kg every week.
Pertuzumab is administered intravenously, and the recommended dose is an initial loading dose of 840 mg followed by a maintenance dose of 420 mg every 3 weeks.
Bevacizumab is administered intravenously, and the recommended dose is 5 mg/kg every 2 weeks or 7.5 mg/kg every 3 weeks.
The dose of trastuzumab should be reduced or discontinued in case of cardiotoxicity or infusion reactions.
The dose of pertuzumab should not be adjusted.
The dose of bevacizumab should be reduced or discontinued in case of hypertension, proteinuria, bleeding, or impaired wound healing.