Greater Glasgow and Clyde Medicines

Restrictions:

Restricted to specialist use in accordance with regional protocols.

Prescribing Notes:

Breast Cancer: click here for regional protocols [NHS network access required]

• Use in the treatment of HER2 positive early breast cancer and metastatic breast cancer is restricted to use in accordance with regional protocol.
• In combination with chemotherapy in the neoadjuvant treatment of adults with HER2 positive, locally advanced, inflammatory, or early stage breast cancer at high risk of recurrence.
• In combination with docetaxel in adults with HER2 positive metastatic or locally recurrent unresectable breast cancer who have not received previous anti-HER2 therapy or chemotherapy for their metastatic disease.
• Use in combination with chemotherapy in the adjuvant treatment of adult patients with HER2-positive early breast cancer at high risk of recurrence (restricted to use in patients with lymph node-positive disease).

BNF Link

Restrictions:

Restricted to specialist use only for the indications listed in the Prescribing notes below.

Prescribing Notes:

Breast Cancer: click here for regional protocols [NHS network access required]

• Use in the treatment of HER2 positive early breast cancer and metastatic breast cancer is restricted to use in accordance with regional protocol (click here).
• In combination with pertuzumab and chemotherapy in the neoadjuvant treatment of adults with HER2 positive, locally advanced, inflammatory, or early stage breast cancer at high risk of recurrence.
• In combination with pertuzumab and docetaxel in adults with HER2 positive metastatic or locally recurrent unresectable breast cancer who have not received previous anti-HER2 therapy or chemotherapy for their metastatic disease.
• Use in combination with pertuzumab and chemotherapy in the adjuvant treatment of adult patients with HER2-positive early breast cancer at high risk of recurrence (restricted to use in patients with lymph node-positive disease)

Cancer of the gastro-intestinal tract: click here for regional protocol [NHS network access required]

• Use, in combination with capecitabine or fluorouracil and cisplatin for the treatment of patients with HER2 positive metastatic adenocarcinoma of the stomach or gastro-oesophageal junction who have not received  prior anti-cancer treatment for their metastatic disease, is restricted to patient whose tumours have HER2 overexpression defined by immunohistochemistry (IHC) 3+ ("HER2 high expresser") in accordance with regional protocol.

BNF Link

Restrictions:

Restricted to specialist use in accordance with regional protocol for the following indications:

• As a single agent for treatment of adults with HER2-positive, unresectable locally advanced or metastatic breast cancer who previously received trastuzumab and a taxane, separately or in combination. Patients whould have either received prior therapy for locally advanced or metastatic disease, or developed disease recurrance during or within six months of completing adjuvant therapy. Click here for regional protocol.
• As a single agent for the adjuvant treatment of adults with HER2-positive early breast cancer who have residual invasive disease, in the breast and/or lymph nodes, after neoadjuvant taxane-based and HER2 targeted therapy.

BNF Link

Restrictions:

Restricted to specialist use in accordance with regional protocol for the following indications:

• As monotherapy for the treatment of adult patients with unresectable or metastatic human epidermal growth factor receptor 2 (HER2)-positive breast cancer who have received one or more prior anti-HER2-based regimens. Click here for regional protocol [NHS network access required].
• As monotherapy for the treatment of adult patients with unresectable or metastatic HER2-low breast cancer who have received prior chemotherapy in the metastatic setting or developed disease recurrence during or within 6 months of completing adjuvant chemotherapy (protocol in development).

BNF Link