Find out what trastuzumab emtansine (Kadcyla) is, how you have it and other important information about having trastuzumab emtansine.
What it is
Trastuzumab emtansine is pronounced trast-oo-zoo-mab em-tan-seen. It is a combination of a drug called trastuzumab and a drug called emtansine. It used to be called T-DM1.
Trastuzumab is a type of biological therapy called a monoclonal antibody. Emtansine is a chemotherapy drug that can kill cancer cells.
Trastuzumab emtansine also has the brand name Kadcyla (pronounced cad-sigh-lah]. It is a treatment for HER2 positive breast cancer that has spread or come back after previous treatment. You normally only have it if you have previously had trastuzumab (Herceptin) treatment.
You may also have trastuzumab emtansine as part of clinical trials for other types of cancer.
How it works
Some breast cancers have too much of a protein called human epidermal growth factor receptor 2 (HER2) on the surface of their cells. These are called HER2 positive cancers. HER2 makes the cells grow and divide. Trastuzumab attaches to the HER2 receptor. When this happens it allows the emtasine to go into the cancer cell. Inside the cell emtansine becomes active and kills the cancer cell.
How you have it
Trastuzumab emtansine is a clear fluid. You have it into your bloodstream (intravenously).
You have the treatment through a drip into your arm. A nurse puts a small tube (a cannula) into one of your veins and connects the drip to it.
You might need a central line. This is a long plastic tube that gives the drugs into a large vein, either in your chest or through a vein in your arm. It stays in while you’re having treatment, which may be for a few months.
When you have it
You have trastuzumab emtansine every 3 weeks. You have the first treatment over 90 minutes. You can have the next treatments over 30 minutes if the first one went well.
You continue to have treatment as long as it controls the cancer. Your doctor might stop treatment if the side effects get too bad.
Tests during treatment
You have blood tests before starting treatment and during your treatment. They check your levels of blood cells and other substances in the blood. They also check how well your liver and kidneys are working.
Other medicines, foods and drink
Cancer drugs can interact with some other medicines and herbal products. Tell your doctor or pharmacist about any medicines you are taking. This includes vitamins, herbal supplements and over the counter remedies.
Pregnancy and contraception
This drug may harm a baby developing in the womb. It is important not to become pregnant or father a child while you are having treatment with this drug and for at least 6 months afterwards. Talk to your doctor or nurse about effective contraception before starting treatment.
Don’t breastfeed during this treatment and for 6 months afterwards. The drug may come through in the breast milk.
You may not be able to become pregnant or father a child after treatment with this drug. Talk to your doctor before starting treatment if you think you may want to have a baby in the future. Men may be able to store sperm before starting treatment. Women may be able to store eggs or ovarian tissue but this is rare.
Treatment for other conditions
Always tell other doctors, nurses, pharmacists or dentists that you’re having this treatment if you need treatment for anything else, including teeth problems.
Don’t have immunisations with live vaccines while you’re having treatment and for at least 6 months afterwards.
In the UK, live vaccines include rubella, mumps, measles, BCG, yellow fever and shingles vaccine (Zostavax).
- have other vaccines, but they might not give you as much protection as usual
- have the flu vaccine
- be in contact with other people who've had live vaccines as injections
Avoid contact with people who’ve had live vaccines taken by mouth (oral vaccines). This includes the rotavirus vaccine given to babies. The virus is in the baby’s urine for up to 2 weeks and can make you ill. So, avoid changing their nappies for 2 weeks after their vaccination if possible. Or wear disposable gloves and wash your hands well afterwards.
You also need to avoid anyone who has had oral polio or typhoid vaccination recently.
More information about this treatment
For further information about this treatment go to the electronic Medicines Compendium (eMC) website.
You can report any side effect you have to the Medicines Health and Regulatory Authority (MHRA) as part of their Yellow Card Scheme.