When to reload Herceptin

[lostdker1]

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Anyone with oncology experience, when do you reload Herceptin? We currently reload if the pt has been off Herceptin for more than 6 weeks, but I'm not sure if that's the right thing to do...

Per lexicomp: "Missed dose recommendation (Canadian labeling, 2012): If a dose is missed by ≤1 week, the usual maintenance dose (based on patient's schedule) should be administered as soon as possible (do not wait until the next planned cycle); if a dose is missed by >1 week, then a loading dose (4 mg/kg if patient receives trastuzumab weekly; 8 mg/kg if on an every-3-week schedule) should be administered, followed by the usual maintenance dose and schedule."

 

[maldini99]

Anyone with oncology experience, when do you reload Herceptin? We currently reload if the pt has been off Herceptin for more than 6 weeks, but I'm not sure if that's the right thing to do...

Per lexicomp: "Missed dose recommendation (Canadian labeling, 2012): If a dose is missed by ≤1 week, the usual maintenance dose (based on patient’s schedule) should be administered as soon as possible (do not wait until the next planned cycle); if a dose is missed by >1 week, then a loading dose (4 mg/kg if patient receives trastuzumab weekly; 8 mg/kg if on an every-3-week schedule) should be administered, followed by the usual maintenance dose and schedule."

what were the circumstances that forced you to stop it?

i think it is reasonable to reload after that period if there is no risk of infusion reaction, low cardiac risk, good perfomance status and the patient has tolerated the drug before well.
it typically comes down to physician preference. i work with two oncologist, one is younger and is typically accepting to following the guidelines and recomendations, while the older one is more reluctant and doses on "intuition".