This essay will discourse the undermentioned statement, ‘All adult females diagnosed with chest malignant neoplastic disease should have Herceptin ‘ . I will speak about what the drug Herceptin is and how it works, speak about its benefits and drawbacks, before reasoning on whether or non I agree with the gap statement. I will get down my essay by sketching what Herceptin is and how it helps conflict chest malignant neoplastic disease.
Breast malignant neoplastic disease is now the most common signifier of malignant neoplastic disease in the UK with about 46,000 new instances diagnosed every twelvemonth. But over the last decennary the decease rate has fallen by a fifth. This is due to increased sensing and intervention of chest malignant neoplastic disease ( Cancer Research UK, 2010 ) . Surveies have shown that 25 % of adult females with chest malignant neoplastic disease have HER2 positive tumors. HER2 is a transmembrane receptor in a group of growing factor receptors ( HER1 – HER4 ) . This receptor is responsible for the cell-cell and cell-stroma communicating through signalling of Ras/mitogen – active protein kinase and phosphatidylinositol 3 kinase ( PI3K ) /Akt tracts. These specific signals are involved in cell proliferation, mobility and endurance ( Dent, 2009 ) . The elaboration of the HER2 cistron consequences in the overexpression of the p185HER2 growing factor which occurs in 25 % of early-stage chest malignant neoplastic diseases with a really hapless clinical result ( Konechy and Untch, 1999 ) . Monoclonal antibodies against the HER2 protein have been studied to demo their ability to suppress human malignant neoplastic disease cell proliferation that is overexpressed by the HER2 receptors. This specific antibody called trastuzumab was seen to suppress tumour growing ( Slamon, 2001 ) . The antibody, besides known as Herceptin, has been shown to better response rate and continuance of chemotherapy and extends survival with HER2 amplified chest malignant neoplastic diseases by 12 months. Herceptin has shown a response rate of 23 % when used as a individual agent. But when Herceptin is used along with chemotherapeutic agents such as Paclitaxel an improved clinical response and drawn-out endurance rate are observe ( Konechy and Untch, 1999 ) . Herceptin binds to the extracellular surface of the HER2 receptor. This adhering blocks HER2-activated cell signalling, which intern reduces cell proliferation and restores the ability for cells to undergo programmed cell death by suppressing the PI3K/Akt tract. This allows for increased cellular sensitiveness for chemotherapy ( Dent, 2009 ) . Herceptin has another mechanism of action, this involves triping monocytic cells to kill the tumor cells by antibody-dependant cell-mediated phagocytosis ( ADCP ) ( Agiannis, 2006 ) . Herceptin has besides been shown to hold cytotoxic belongingss which may be due to the activation of antibody-dependant cellular cytotoxicity ( ADCC ) . ADCC is an immunological consequence which is due to the activation of natural slayer cells that activate the lysis of Herceptin edge malignant neoplastic disease cells. Herceptin besides suppresses angiogenesis with the initiation of antiangiogenic factors and a decrease of proangiogenic factors. In a survey utilizing mice with HER2-positive chest malignant neoplastic disease, the mice were treated with Herceptin and Paclitaxel. A response was observed which showed a nice harmony between tumour response and a decrease in microvessel denseness ( Valabrega et al, 2007 ) . The following subdivision will travel into the inside informations of administrating the drug Herceptin to patients with breast malignant neoplastic disease.
Herceptin is recommended for the intervention of adult females with early-stage HER2-positive chest malignant neoplastic disease every bit good as chemotherapy and in some instances radiotherapy. Womans with pre bing cardiac jobs such as left ventricular expulsion fraction of 55 % or less, a history of congestive bosom failure, ill controlled high blood pressure and other related bosom jobs. Herceptin is normally given at 3-week intervals for one twelvemonth or until the chest malignant neoplastic disease comes back ( if before the one twelvemonth period ) . Besides a 1-week regimen is available in some instances. The 3-week regimen of Herceptin gives a dosage of 8mg/kg organic structure weight followed by 6mg/kg every 3-weeks for the twelvemonth. The 1-week regimen gives a get downing dosage of 4mg/kg followed by 2mg/kg every hebdomad for that twelvemonth. Herceptin is a instead dearly-won drug with a monetary value of & A ; lb ; 407.40 for 150mg. The costs of these two governments differ with the 3-week regimen bing & A ; lb ; 24,600 a twelvemonth whereas the 1-week costs & A ; lb ; 28,000 a twelvemonth ( NICE, 2006 ) . Herceptin overall is a really good drug, here are some of its benefits.
The intervention of Herceptin with chemotherapy can demo a 1 twelvemonth endurance rate of 79 % ( Rang et al, 2003 ) . The dose and regimen of dose helps with the intervention. The hebdomadal and 3 hebdomad interventions help to cut down the size of HER2 positive tumors that have spread from another portion of the organic structure and cut down the opportunity of remittal. Although Herceptin ‘s benefits are really of import in the endurance of adult females with HER2- positive chest malignant neoplastic disease there are some drawbacks of the drug.
Adverse effects can fall into two classs, cardiotoxicity and infusion-associated symptoms. Cardiotoxicity can happen in 4 % of patients having Herceptin. Symptoms of this can include dyspnoea ( shortness of breath ) , coughing, paroxysmal nocturnal dyspnoea and peripheral hydrops ( swelling of peripheral tissues ) . Infusion-associated symptoms are seen during the first extract of Herceptin. Symptoms such as icinesss and febrilities are seen in up to 40 % of patients. Other symptoms include sickness, purging, hurting, asperities, concern, giddiness, roseola and astheny ( Ngan, 2009 ) . Patients that are treated with Herceptin were seen to hold a high hazard of cardiac disfunction. This job was seen in 3 % – 7 % of patients having the drug. But this hazard of cardiac disfunction is justified for the endurance of metastatic chest malignant neoplastic disease ( Seidman, 2002 ) . I will now reason by mentioning back to the get downing statement.
After researching the chest malignant neoplastic disease drug Herceptin I will now be able to do an overall decision of the statement, ‘All adult females diagnosed with chest malignant neoplastic disease should have Herceptin ‘ . I neither agree or disagree with this statement as Herceptin should n’t be given to all adult females with chest malignant neoplastic disease. Herceptin is n’t required for all adult females with beast malignant neoplastic disease as there are many types of chest malignant neoplastic disease that are n’t affected by intervention with Herceptin. Herceptin is effectual towards adult females with HER2-positive early phase chest malignant neoplastic disease. Given in a controlled government and along with chemotherapy, Herceptin can demo a 1 twelvemonth endurance rate of up to 79 % ( Rang et al, 2003 ) . It can assist cut down the size of chest tumors and cut down remittal rates. A cardinal factor in the production and intervention of Herceptin is down to the cost of the drug. Herceptin is an expensive drug to do and costs & A ; lb ; 407.40 for 150mg. The highest cost for a twelvemonth government of Herceptin is & A ; lb ; 28,000 ( NICE, 2006 ) , and giving this drug to every adult female with chest malignant neoplastic disease would make a immense cost for the NHS. Equally good as cost there are besides many jobs due to side effects and jobs that occur after disposal of the drug. Cardiac jobs such as cardiac disfunction can be seen in 3 % – 7 % of adult females having the drug Herceptin ( Seidman, 2002 ) . So before the drug is administered cardiac trials must be carried out to do certain the patient is healthy plenty to have the drug. Many other side effects are observed such as dyspnoea, coughing, paroxysmal nocturnal dyspnoea and peripheral hydrops. So as before adult females should be off full wellness before having Herceptin. Finally I believe that the statement given is neither right non wrong. If I was to alter the statement to do it right I would state, ‘All adult females diagnosed with HER2 early phase chest malignant neoplastic disease should have Herceptin depending on their wellness state of affairs. ‘