Does trastuzumab increase the risk of infection?

The authors aimed to determine whether or not the breast cancer treatment trastuzumab (Herceptin) increased the risk of developing certain infections.

Human epidermal growth factor receptor positive (HER2+) breast cancers are dependent on the HER2 protein for growth. It is often targeted with a particular anti-HER2 therapy drug called trastuzumab (Herceptin). This drug targets the HER2 receptor and blocks the tumor’s ability to grow.

Previous studies have attempted to associate the risks of possible infections with this type of therapy. The overall risks, however, are still not well understood.

The aim of this study was to assess the safety profile of trastuzumab therapy in relation to the increased risk of infections.

A total of 10,094 patients from 13 different clinical trials were evaluated for this study. Out of these patients, 4365 were allocated to a course of trastuzumab while 6729 were treated with other agents and used for comparison (the control group).

Overall, there was a significant increase (21%) in the risk of high-grade infections (grades can range from mild to life-threatening) in those who received trastuzumab compared with the control group.

5464 patients were evaluated for the developments of febrile neutropenia (the development of a fever in a patient an abnormally low count of neutrophils – a type of white blood cells). Those who received trastuzumab had an increased risk of developing febrile neutropenia (12%) compared to the control group (10%).

Patients receiving trastuzumab in conjunction with combined chemotherapy treatment (more than one drug), had the most significant increase in infection risk.

The authors concluded that trastuzumab was associated with an increased risk of high-grade infection and febrile neutropenia. 

If you are receiving any type of trastuzumab treatment and begin to develop a fever or other types of infections, consult your doctor.