Abstract

EVALUATION OF INFUSION RELATED REACTIONS AND RISK FACTORS ASSOCIATED WITH TRASTUZUMAB INFUSION

*G. Sathyaprabha, Chinju Rajan and Sneha Elizabeth

ABSTRACT

Trastuzumab is a humanized monoclonal antibody used for the treatment of Human Epidermal Growth Factor Receptor-2 overexpressed breast cancer. Like many Monoclonal antibodies, Trastuzumab is associated with Infusion Related Reaction (IRRs). The incidence of IRR varies widely between reports. Materials and Methods: A retrospective chart review of Breast cancer patients who treated with Trastuzumab was conducted. The objective was to find out the incidence and risk factors associated with Trastuzumab infusion. Results: A total of 65 patients who received Trastuzumab (672 doses) were evaluated. Two reactions were observed in two patients, resulting in an incidence of 3% of patients and 0.29% of total doses. All the reactions were of Grade 2. The infusion related reactions produced were effectively managed by administering supportive medications. By univariate regression analysis, BMI was found to be a risk factor for IRRs. From the analysis of premedications it was found that the use of Dexamethasone as premedications may not be required after the first two infusions of Trastuzumab. Conclusion: The results support that infusion related reactions produced mild to moderate in severity and were effectively managed with supportive medications. The infusion duration of 45 minutes ± 5 minute was considered safe from the study. This study also supports omitting the steroid as a premedication after the first two infusions of Trastuzumab. Furthur evaluation of Trastuzumab doses are necessary to find out the risk factors behind the IRRs.

Keywords: Trastuzumab, Infusion related Reactions, Body mass index, Dexamethasone.