UK clinical guideline on Herceptin
UK clinical guideline on Herceptin The National Cancer Research Institute has produced a UK Clinical Guideline on the use of Herceptin for early breast cancer. This provides useful information to those considering prescribing Herceptin for this indication in advance of a decision on licensing and the publication NICE guidance.
Kind regards
BCC Moderator
— Have just read this and it is very interesting- should help Doctors and also HER2 + women to make the best choices.
The worm is turning… very slowly, but it is turning…
Jen
Hospital or home? Para 5.4 of the guideline says: " Herceptin should only be administered by appropriately trained staff with immediate access to apprpriate access to deal with anaphylaxis." I think this means the recommendation is for hospital administartion. This is the " Committee" referred to.
K
Brilliant It is nice to see some sensible action.
I don’t think that this really addresses the herceptin at home issue. Whatever the problem is for my oncologist, it is a body that is not acting rather than one that is recommending herceptin only in a hospital.
The Healthcare at Home staff reassured me that they are trained in dealing with anaphalaxis. After all, they give taxanes to people in their homes, so they need to be able to manage severe allergic reactions.
Herceptin Good document - something else to quote at PCT appeal next week (but I still think they will turn it down again).
Straying a bit off topic (and I’ll copy it to the herceptin at home thread) - My understanding of nurse training/accreditation to give IV drugs is that this will require them to do specific training around the issue of anaphylaxis - recognising it, managing it… Home administration of IV drugs on the NHS is not unheard of - the trust I work for employees a number of nurses who do just this - not sure about the detail of when the service they provide is used, think its completion of courses of antibiotics etc when the individual concerned doesn’t need to be in hospital.
timing of herceptin I thought this was a useful article but was confused that they talk of giving herceptin within 6 months of last chemo. Had the understanding from oncs and here that it was 6 months after completion of treatment. Can anyone clarify?
All the best,
Sharon
SharonC Very politely expressed hope, but either you or your oncologists are confused! The standard protocols being followein the UK, in line with the major trials, is ideally to administer Herceptin within 6 months of completeing chemotherapy, i.e. before the expiry of 6 months from the last chemo treatment.date.
NB: You will see from the Guidelines document that it refers to continuing with Herceptin during radiotherapy (as indeed I did).
Timing Section 4.3 details scheduling of herceptin. It quotes info from HERA (unpublished data) that whilst the median interval between the date of last chemo and the date of the first herceptin was 89 days, the range of time was actually 4 to 320 days. From this they have produced the UK recomendation that starting at any time up to 6 months after chemotherapy is acceptable.
The document goes on to say that there is no data to suggest that those starting after a longer time interval have failed to benefit. Also acknowledged is that this is an important issue which will remain under review.