Trastuzumab exposure in early pregnancy for a young lady with locally invasive breast cancer

American Journal of BioMedicine  Volume 2, Issue 8, pages 899-902, August 2014

Natasha Pianca; Mathew George


The available literature on the effects of trastuzumab on pregnancy in the first trimester is limited. Case reports discuss the presence of oligohydramnios on fetal USS that result in a living baby that seemingly lacks any abnormalities. There may also be a link with higher rates of spontaneous abortion. We describe a young 32 year old on trastuzumab for a locally invasive HER2-positive breast cancer who became pregnant with fetal exposure to the treatment. After cessation of trastuzumab at 28 weeks, she delivered a healthy baby girl at 37 weeks gestation who, at 7 years of age now, still does not display any evidence of negative effects of trastuzumab exposure.   

Keywords: Trastuzumab; Breast cancer; HER2-positive; Pregnancy; Oligohydramnios

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1. Bleiweiss IJ, MD. Pathology of breast cancer. In: Up To Date, Chagpar AB, Duda RB. Last updated Dec 19, 2013, Literature current Feb 2014. [Website]

2. Esserman LJ, Joe BN. Clinical features, diagnosis, and staging of newly diagnosed breast cancer. In: Up To Date, Gralow JR, Duda RB. Last updated May 20, 2013, Literature current Feb 2014. [Website]

3. Pharmaceutical Benefits Scheme. Trastuzumab, powder for I.V. infusion, 60mg and 150mg, Herceptin®. Australian Government Department of Health, Public Summary Document Roche Products Pty Ltd. [Website]

4. Hudis CA. Trastuzumab – Mechanism of Action and Use in Clinical Practice. New England Journal of Medicine 2007; 357: 39-51. [PubMed]

5. US Food and Drug Administration. Trastuzumab – (Labelling Change). U.S. Department of Health and Human Services updated February 11, 2010. [Website]

6. Waterston AM, Graham J. Effect of Adjuvant Trastuzumab on Pregnancy. Journal of Clinical Oncology 2006; 24(2): 321-322. [PubMed]

7. Pant S, Landon MB, Blumenfeld M, Farrar W, Shapiro C. Treatment of Breast Cancer With Trastuzumab During Pregnancy. Journal of Clinical Oncology 2010; 26 (9):1567-1569. [PubMed]

8. Azim HA, Peccatori FA, Liptrott SJ, Catania C, Goldhirsch A. Breast cancer and pregnancy: how safe is trastuzumab? Nature Reviews Clinical Oncology 2009; 6: 367-370. [PubMed]

9. Goldhirsch A, Gelber RD, Piccart-Gebhart MJ, de Azambuja E, Procter M, Suter TM, et al. 2 years versus 1 year of adjuvant trastuzumab for HER2-positive breast cancer (HERA): an open-label, randomised controlled trial. The Lancet 2013; 382(9897): 1021-1028. [PubMed]

10. Azim HA, Metzger-Filho O, Azambuja E, Loibl S, Focant F, Gresko E, Arfi M, Piccart-Gebhart M. Pregnancy occurring during or following adjuvant trastuzumab in patients enrolled in the HERA trial (BIG 01-01). Breast Cancer Research and Treatment 2012; 133(1): 387-391. [PubMed]

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