Hello everyone
I am writing this from Mongolia
I am 44 years old just diagnosed left breast cancer and wend under operation 10 days ago for total removal of left breast
Now i need herceptin injection and i am quite confused and please tell me about more
Shall i choose Canmab or Herclon or etc
i inderstand all of them exact same as HERCEPTIN, is that right?
Also where i can find
Thank you all
They are the same, Herceptin is the Roche product, and they still have a patent for the ingredient, Trastuzumab. Herclon is made in India under a Roche license. I think Canmab is made under no license, but it still contains Trastuzumab, and that is what interest you. But Canmab has a little less security:
firstwordpharma.com/node/11...
I assume you have a HER2 positive cancer - that is why Trastuzumab is advised. The medication contributes to killing cancer cells in the body (the invisible ones that have spread), if they are HER2+.
Trastuzumab must be taken for e year, if the cancer is HER2+. Normally (in virtually all cases) you also have chemo therapy for a number of weeks after the surgery (see below). Chemo therapy also contributes to kill cancer cells in the body. Together the drugs prevent "distant recurrence", i.e. cancers elsewhere than the breast - the so-called "distant metastases".
You must be careful with Trastuzumab - it may impair the heart function, so during the year in which you take it, the socalled LVEF must be measured at regular intervals. Also be careful if there are other heart problems, but you presumably don't have them. So Trastuzumab is one of the so-called wonder drugs, it has improved the condition of many that would otherwise be at risk with HER2 positive cancers (18% of all breast cancers).
What about other chemo therapy? It should be given before Trastuzumab, at least the drugs containing anthracyclines, which do not interact well with Trastuzumab.
And if it is either estrogen or progesteron receptor positive (ER+ or PR+), then it is hormone receptor positive, and you should take Tamoxifen for at least 5 years after the chemo therapy. So is it ER+ or PR
[This part of the reply you must check with the doctor treating you: The dosage of Herceptin when given intravenously (IV - in a hospital) is 6 mg per kg of body weight once every 3 weeks (assuming you go to the hospital every 3 weeks for a year). So if you weigh e.g. 60 kg, the dosage is 360 mg - Canmab comes in doses of 440 mg, most suitable for a person weighing 73 kg]
Hi kaarenorgaard
Thank you so much for your help
Ok so herclon is safer than
About ER and PR is, they are negative
Also doctors said trastuzumab will go together with chemo, and last one
where i can find trusted Herclon from Indian market?
Thanks for your help
I am in Denmark and I don't know about how to get it from India.
Try to Google it, I think distributors come up. What do hospitals do in your region?
Thanks for your reply
To be honest they not going to do anything, i mean hospital in Mongolia
But if i have injection they will do for me, but now i am little worried after chatting with you, as you said it is seems they supposed to go separate, i mean chemo and herceptin, is that correct?
Forget one thing, doctors said i need 6 injection, which is 4.5 months, well i dont know
Thank you very much for your time
As for Trastuzumab, the standard is one year of treatment at least elsewhere. So 52 weeks, one injection each 3 weeks (that is at least 51 weeks, 17 injections).
Tell me what chemo drugs you have, then I can tell you what to not have at the same time as Trastuzumab (it is normally said that Trastuzumab must wait for all of the anthracyclines - part of the chemo therapy - to be finished, before Trastuzumab can start).
It is known that if Trastuzumab is taken at the same time as anthracyclines, then the heart is at a higher risk than otherwise.
If in doubt, wait with the Trastuzumab until all of the chemo therapy has finished. And then get the heart monitored (Left Ventricular Ejection Function, LVEF) at regular intervals during that year of treatment - it must be I think at least 55% in the beginning and mustn't drop more than 10% during the period in which you take Trastuzumab, because if it does so, your heart is at risk.
Finally, is the cancer estrogen receptor (ER) positive?
(And since you need Trastuzumab, it must be HER2 positive ...? Let's check that, now we are at it)
Sorry, you did say it was ER negative. But just checking, it is HER2 positive?
Hi Kaare
My ER is negative which i heard not good sigh either
And my chemo is Taxal going with herceptin which i choose Canmab because of my budget
Suppose to start on next Thursday, but still couldnt find the way to get my Canmab, i guess i can start Taxal first and in between 3 weeks i can add Canmab
i dont know
Thanks Amra
Taxol (or Taxal) is not an anthracycline, so you can take them together. But in some countries they wait for the chemo to be completed, before they start the Trastuzumab (Canmab)
Thanks Kaare
I too had removal of the left breast, then chemotherapy and radiation and a whole year of trastuzumab - Canmab in my case (I am HER2+), which I was told was as effective as the more expensive Roche product. I bought the Canmab from a chemist in Mumbai (India) where I live, called Medilab Pharma. It is manufactured by Biocon Ltd, a Bangalore (India) based company.
Thank you soo much for your response, I have few question and could you kindly tell me please.
1. I am going take Canmab than but i live in Mongolia, can i buy 8 injection one time and keep rest of them until next treatments( is it safe)?
2. How much will cost per injection?
3. Where can i buy or contact since i am from oversees?
Thanks again
What I was told is that once you open the injection package you can only keep it in a refrigerator for 3 weeks. (In the beginning I was not given the full dose so some was left over for the next time.) But I don't know for how long you can keep an unopened pack.
The cost per injection is Rs 57,000. I don't know how much that is in your currency.
You are sure to find Biocon, which manufactures Canmab, on the net. Try contacting them.
Medicines can also be ordered online here in India but I don't know how reliable that will be.
Surely you own doctor will be able to tell you where you can get medications?
Thank you soo much your reply, god blees you
Please see this link on the product CANMAB - it says you can store it for 1 month:
biocon.com/biocon_products_...
But you must have it for a year, so I guess you have to set up a supply each month of that year.
And I just want to make sure: start it AFTER the chemotherapy to reduce risk of heart problems (at least after the anthracycline part of the chemo therapy).
Best wishes!
Kaare
Thank you soo much Kaare
Just to clarify a bit about your question, they are not 'exact' same, but 'similar'. Trastuzumab is the original molecule, whereas the ones like Canmab are called as 'Biosimilars'. Of course, USFDA has accepted them and there should be no reason you may not use them.
You must ask your Oncologist who has prescribed this to you, in detail about the two and you must take his help in selecting which one. All these companies also have schemes going on, time and again, where sometimes they give an extra injection free or sometimes they may give two cycles of chemotherapy and such. Your treating Oncologist will surely know if any scheme going on and you can accordingly go for it
Can anyone tell me what are the side effects of Trastuzumab? My mom is done with her 4+12 cycles of chemos and surgery. She was ER PR & HER2 negative initially but post surgery reports states that she is HER2 positive.
She might have to start with herceptine . She has struggled a lot to overcome chemos. I am scared of the side effects of these drugs. Hope these are safer than chemos
I dont know that much, havent started yet my chemo, but about herceptins sude effect is mostly heart failure, so if your mums heart is ok should be fine
Best wishes
About Treatment of HER2 positive node negative right breast cancer in the cheapest way possible 
Breast Cancer resurfaced 
Stage 2 Breast Cancer with Lymphovascular Invasion.
