Adaptation syndrome
Her-2/neu gene over-expression of the period of operable breast cancer.
1.Her-2/neu gene over-expression means: immunohistochemistry (IHC) 3 +, or fluorescence in situ hybridization (FISH)-positive, or the pigment in situ hybridization (CISH)-positive.
2.Her-2 IHC2 + patients clearly merits further FISH or CISH.
The role of Herceptin
The ongoing clinical study of the initial indications: For the Her-2/neu gene over-expression of breast cancer adjuvant treatment with Herceptin for one year can reduce the recurrence of breast cancer.
Herceptin is a biological targeting agents, after more than 10 years of clinical use confirm that it’s less toxic side effects, more serious side effects when it is combined with anthracycline use will increase the chance of congestive heart failure.
Pre-treatment preparation
Accurate Her-2/neu detection. Suggested that fresh (frozen) tissue, or paraffin (wax block or white sheet) sent to the Pathology of domestic conditions for review.
Cardiac function tests (heart ultrasound or isotope scanning).
Informed consent form signed by the treatment.
Treatment program and pay attention to matters of
Herceptin 6mg/kg (first dose 8mg/kg) every 3-week program, or 2mg/kg (first dose 4mg/kg) weekly program. The time being, the recommended treatment time for 1 year.
Observed after the first treatment 4-8 hours.
Over the same period with anthracycline chemotherapy should be carefully, but can be sequential applications. With non-anthracycline chemotherapy, endocrine therapy and radiation therapy can be applied over the same period.
Once every 4-6 months to monitor LVEF. If there is treatment LVEF below 50%, treatment should be suspended, and track and monitor the LVEF results, until the resumption of more than 50% may continue medication. If restored, or continue to deteriorate, or there is heart failure-like Herceptin treatment should be discontinued.
