Chemotherapy (chemo) drugs target cells that divide rapidly, which is why they are often effective against cancer cells. But there are other aspects of cancer cells that make them different from normal cells. In recent years, researchers have developed several new targeted drugs to try to exploit these differences. Targeted drugs generally do not have the same types of severe side effects as standard chemo drugs.
About 1 out of 5 of patients has too much of a growth-promoting protein called HER2/neu (or just HER2) on the surface of their stomach cancer cells. Tumors with increased levels of HER2/neu are called HER2-positive. Trastuzumab (Herceptin) is a drug that targets HER2. Trastuzumab is a type of drug known as a monoclonal antibody — a man-made version of a very specific immune system protein. It is used more often to treat breast cancer. In patients whose cancers are HER2-positive, giving trastuzumab with chemo can help patients with metastatic gastric cancer live longer than giving chemo alone.
Trastuzumab is injected into a vein (IV). For stomach cancer it is given every 3 weeks along with chemo. The best length of time to continue to give it is not yet known.
The side effects of trastuzumab are relatively mild. They may include fever and chills, weakness, nausea, vomiting, cough, diarrhea, and headache. These side effects occur less often after the first dose. This drug can also rarely lead to heart damage. The risk of heart damage is increased if trastuzumab is given with certain chemo drugs called anthracyclines. Examples of anthracyclines include epirubicin (Ellence) and doxorubicin (Adriamycin).
Since this drug only works if the cancer cells have too much HER2, samples of the patient's tumor must be tested to look for HER2. This was discussed in the section, “How is stomach cancer diagnosed?”
Other targeted therapy drugs are being tested against stomach cancer. Some of these are discussed in more detail in the section “What's new in stomach cancer research and treatment?”
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