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Cisplatin, fluorouracil (5-FU) and trastuzumab

Find out about the drug combination of cisplatin, fluorouracil and trastuzumab, how you have it and other important information.

Cisplatin and fluorouracil (5-FU) are chemotherapy drugs. Trastuzumab is a targeted cancer drug called a monoclonal antibody (a biological therapy). You can have them together as a treatment for stomach cancer that’s advanced and HER2 protein positive.

How you have it

You’ll have cisplatin, fluorouracil and trastuzumab as cycles of treatment.

You have cisplatin and fluorouracil into your bloodstream (intravenously). You can have the drugs through a thin, short tube (a cannula) put into a vein in your arm each time you have treatment.

Or you can have them through a central line, a PICC line or a portacath. These are long, plastic tubes that supply the drugs into a large vein in your chest. The tube stays in place throughout the course of treatment.

cisplatin, fluorouracil and trastuzumab.png

You can have fluorouracil in a pump which stays attached for a number of days, allowing you to move around easily with your chemotherapy. It’s quite small and attached to your central line.

Where you have treatment

You usually have this treatment in the day unit. Then you go home with the 5-FU going through the pump into your central line. A nurse can disconnect your pump at the end of the 5 days.

Having fluids through a drip with cisplatin can take a few hours. Take something with you to keep you occupied.

You’ll need to stay on the unit for a few hours after having trastuzumab. Depending on how you are, it might be shorter the next time.

You might have your chemotherapy cycle as an inpatient. You’ll get information from your team about what to expect about staying in hospital. This includes what to bring with you and when people can visit.

When you have treatment

You may have up to 6 cycles of treatment. You might continue to have trastuzumab for as long as it’s working. Each cycle lasts 3 weeks (21 days). 

On the first day of the cycle you have:

  • cisplatin through a pump for between 1 to 8 hours
  • extra fluids through a drip before and after the cisplatin to protect your kidneys
  • 5-FU as a drip through a pump every day or continuously for 5 days

The pump might be a small portable one if you have a long line. This means that you can go home with it. You go back to the hospital for the nurses to refill it or disconnect it.

Your doctor or nurse will tell you when you need to go back.

You have trastuzumab through a drip or by an injection under the skin (subcutaneous) once every cycle. Having trastuzumab into a vein takes about 30 to 90 minutes each time.

Tests during treatment

You have blood tests and other tests before starting treatment.

The blood tests check your levels of blood cells. They also check how well your liver and kidneys are working.

You’ll have hearing tests throughout your treatment.

You’ll have a heart scan before, during and after your treatment.

Side effects

Important information

Other medicines, food 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 treatment might harm a baby developing in the womb. It is important not to become pregnant or father a child while you're having treatment and for a few months afterwards. Talk to your doctor or nurse about effective contraception before starting treatment.

Breastfeeding

Don’t breastfeed during this treatment because the drugs may come through in your breast milk.

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.

Immunisations

Don’t have immunisations with live vaccines while you’re having treatment and for up to 12 months afterwards. The length of time depends on the treatment you are having. Ask your doctor or pharmacist how long you should avoid live vaccinations.

In the UK, live vaccines include rubella, mumps, measles, BCG, yellow fever and the shingles vaccine (Zostavax).

You can:

  • have other vaccines, but they might not give you as much protection as usual
  • have the flu vaccine (as an injection)
  • be in contact with other people who have had live vaccines as injections

Avoid close contact with people who have recently had live vaccines taken by mouth (oral vaccines) such as oral polio or the typhoid vaccine.

This also includes the rotavirus vaccine given to babies. The virus is in the baby’s poo for up to 2 weeks and could 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 should also avoid close contact with children who have had the flu vaccine nasal spray if your immune system is severely weakened. 

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.

Last reviewed: 
28 Jul 2016
  • Electronic medicines compendium, SPC and PILs
    Accessed May 2016

  • Cisplatin/ 5-Fluorouracil (+ Trastuzumab) in Gastric Cancer
    South East London Cancer Network, 2011.

  • Molecular basis of 5-fluorouracil-related toxicity: lessons from clinical practice
    Papanastasopoulos P, Stebbing
    Journal of Anticancer Research 2014. Vol 34, Issue 4.

  • Trastuzumab in gastric cancer
    South East London Cancer Network, 2011

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