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Textbook and Publication Errata
Lexi-Comp's Drug Information Handbook for Oncology (5th Edition) error in the Trastuzumab monograph
Following the printing of the Drug Information Handbook for Oncology, 5th Edition, an error in the Trastuzumab monograph was identified. The Use, Labeled Contraindications, and Warnings/Precaution fields were affected. The corrected information is listed below. This corrected information has been reproduced in a format suitable for easy insertion into the Drug Information Handbook for Oncology, 5th Edition (page 790). If you have a copy of the 5th Edition, and would like to receive the insert of corrected information, please contact Lexi-Comp’s customer service department at 1.866.397.3433. Unsold copies of the Handbook are being corrected prior to distribution.
Use Treatment of metastatic breast cancer whose tumors overexpress the HER-2/neu protein
Labeled Contraindications Hypersensitivity to trastuzumab, Chinese hamster ovary cell proteins, or any component of the formulation.
Warnings/Precautions Hazardous agent - use appropriate precautions for handling and disposal. Congestive heart failure associated with trastuzumab may be severe and has been associated with disabling cardiac failure, death, mural thrombus, and stroke. Left ventricular function should be evaluated in all patients prior to and during treatment with trastuzumab. Discontinuation should be strongly considered in patients who develop a clinically significant decrease in ejection fraction during therapy. Combination therapy which includes anthracyclines and cyclophosphamide increases the incidence and severity of cardiac dysfunction. Extreme caution should be used when treating patients with pre-existing cardiac disease or dysfunction, and in patients with previous exposure to anthracyclines. Advanced age may also predispose to cardiac toxicity.
Serious adverse events, including hypersensitivity reaction (anaphylaxis), infusion reactions (including fatalities), and pulmonary events (including adult respiratory distress syndrome) have been associated with trastuzumab. Most of these events occur within 24 hours of infusion, however, delayed reactions have occurred. Use with caution in pre-existing pulmonary disease. Discontinuation of trastuzumab should be strongly considered in any patient who develops anaphylaxis, angioedema, or acute respiratory distress syndrome. Retreatment of patients who experienced severe hypersensitivity reactions has been attempted (with premedication). Some patients tolerated retreatment, while others experienced a second severe reaction. When used in combination with myelosuppressive chemotherapy, trastuzumab may increase the incidence of neutropenia (moderate-to-severe) and febrile neutropenia.
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