- Approval Id
- 5f59ab83159be25f
- Drug Name
- KADCYLA POWDER FOR CONCENTRATE FOR SOLUTION FOR INFUSION 100MG/VIAL
- Product Name
- KADCYLA POWDER FOR CONCENTRATE FOR SOLUTION FOR INFUSION 100MG/VIAL
- Approval Number
- SIN14497P
- Approval Date
- 2014-01-24
- Registrant
- ROCHE SINGAPORE PTE. LTD.
- Licence Holder
- ROCHE SINGAPORE PTE. LTD.
- Drug Type
- Therapeutic
- Forensic Classification
- Prescription Only
- Dosage Form
- INJECTION, POWDER, FOR SOLUTION
- Dosage
- <p><strong>2.2 Dosage and Administration<br>
IN ORDER TO PREVENT MEDICATION ERRORS IT IS IMPORTANT TO CHECK THE VIAL LABELS TO ENSURE THAT THE DRUG BEING PREPARED AND ADMINISTERED IS KADCYLA (TRASTUZUMAB EMTANSINE) AND NOT TRASTUZUMAB (HERCEPTIN).</strong></p>
<p>Kadcyla therapy should only be administered under the supervision of a healthcare professional experienced in the treatment of cancer patients.<br>
Patients treated with Kadcyla should have HER2 positive tumour status, defined as a score of 3+ by immunohistochemistry (IHC) or a ratio of ≥ 2.0 by in situ hybridization (ISH) or by fluorescence in situ hybridization (FISH) assessed by a validated test.</p>
<p>Substitution by any other biological medicinal product requires the consent of the prescribing physician.</p>
<p>The safety and efficacy of alternating or switching between Kadcyla and products that are biosimilar but not deemed interchangeable to Kadcyla has not been established. Therefore, the benefit/risk of alternating or switching needs to be carefully considered.</p>
<p>Kadcyla must be reconstituted and diluted by a healthcare professional and administrated as an intravenous infusion <em>(see section 4.2 Special Instructions for Use, Handling and Disposal</em> – <em>please refer to the Product Insert/Patient Information Leaflet published on HSA for the full drug information</em><em>)</em>. Do not administer as an intravenous push or bolus.</p>
<p><em><strong>Schedule</strong></em><br>
The recommended dose of Kadcyla is 3.6 mg/kg given as an intravenous infusion every 3 weeks (21-day cycle).</p>
<p>Administer the initial dose as a 90-minute intravenous infusion. Patients should be observed during the infusion and for at least 90 minutes following the initial dose for fever, chills, or other infusion-related reactions. The infusion site should be closely monitored for possible subcutaneous infiltration during drug administration <em>(see section 2.4.1 General, Warnings and Precautions, Extravasation</em> – <em>please refer to the Product Insert/Patient Information Leaflet published on HSA for the full drug information</em><em>)</em>.</p>
<p>If prior infusions were well tolerated, subsequent doses of Kadcyla may be administered as 30-minute infusions and patients should be observed during the infusions and for at least 30 minutes after infusion.</p>
<p>The infusion rate of Kadcyla should be slowed or interrupted if the patient develops infusion-related symptoms <em>(see section 2.4.1 General, Warnings and Precautions</em> – <em>please refer to the Product Insert/Patient Information Leaflet published on HSA for the full drug information</em><em>)</em>. Discontinue Kadcyla for life-threatening infusion reactions.</p>
<p><em><strong>Duration of treatment</strong></em><br>
Patients with EBC should receive treatment for a total of 14 cycles unless there is disease recurrence or unmanageable toxicity.</p>
<p>Patients with MBC should receive treatment until disease progression or unmanageable toxicity.</p>
<p><em><strong>Delayed or missed dose</strong></em><br>
If a planned dose of Kadcyla is missed, it should be administered as soon as possible; do not wait until the next planned cycle. The schedule of administration should be adjusted to maintain a 3-week interval between doses. The infusion may be administered at the rate the patient tolerated the most recent infusion.</p>
<p><em><strong>Dose modifications</strong></em><br>
Management of symptomatic adverse events may require temporary interruption, dose reduction, or treatment discontinuation of Kadcyla as per guidelines provided in Tables 1 and 2.</p>
<p>Kadcyla dose should not be re-escalated after a dose reduction is made.</p>
<img src="/TGIF/Kadcyla-Table1_050422.png" alt="Kadcyla Dosage Table 1" /><br><br>
<img src="/TGIF/Kadcyla-Table2a_050422.png" alt="Kadcyla Dosage Table 2" /><br><br>
<img src="/TGIF/Kadcyla-Table2b_050422.png" alt="Kadcyla Dosage Table 2" /><br><br>
<p><strong>2.2.1 Special Dosage Instructions<br>
<em>Geriatric use</em></strong><br>
There are insufficient data to establish the safety and efficacy of Kadcyla in patients 75 years of age or older. No dose adjustment of Kadcyla is required in patients aged ≥ 65 years <em>(see section 2.5.5 Geriatric Use</em> – <em>please refer to the Product Insert/Patient Information Leaflet published on HSA for the full drug information</em><em>)</em>.</p>
<p><em><strong>Pediatric use</strong></em><br>
The safety and efficacy of Kadcyla in children and adolescents (< 18 years) have not been established.</p>
<p><em><strong>Renal impairment</strong></em><br>
No adjustment to the starting dose of Kadcyla is needed in patients with mild or moderate renal impairment <em>(see section 3.2.5 Pharmacokinetics in Special Populations</em> – <em>please refer to the Product Insert/Patient Information Leaflet published on HSA for the full drug information</em><em>)</em>. The potential need for dose adjustment in patients with severe renal impairment cannot be determined due to insufficient data.</p>
<p><em><strong>Hepatic impairment</strong></em><br>
No adjustment to the starting dose is required for patients with mild or moderate hepatic impairment <em>(see section 3.2.5 Pharmacokinetics in Special Populations</em> – <em>please refer to the Product Insert/Patient Information Leaflet published on HSA for the full drug information</em><em>)</em>. Kadcyla has not been studied in patients with severe hepatic impairment. Treatment of patients with hepatic impairment should be undertaken with caution due to known hepatotoxicity observed with Kadcyla <em>(see section 2.4 Warnings and Precautions, General, Hepatotoxicity</em> – <em>please refer to the Product Insert/Patient Information Leaflet published on HSA for the full drug information</em><em>)</em>.</p>
- Route Of Administration
- INTRAVENOUS
- Indication Info
- <p><strong>2.1 Therapeutic Indication(s)<br>
Breast Cancer</strong><br>
<em>Metastatic Breast Cancer (MBC)</em><br>
Kadcyla, as a single agent, is indicated for the treatment of patients with HER2-positive, unresectable locally advanced or metastatic breast cancer who have received prior treatment with trastuzumab and a taxane, separately or in combination. Patients should have either:</p>
<ul class="dash">
<li>Received prior therapy for advanced or metastatic disease, or</li>
<li>Developed disease recurrence during or within six months of completing adjuvant therapy.</li>
</ul>
<p><em>Early Breast Cancer (EBC)</em><br>
Kadcyla, as a single agent, is indicated for the adjuvant treatment of patients with HER2-positive early breast cancer who have residual invasive disease, after neoadjuvant trastuzumab and taxane-based treatment.</p>
- Contraindications
- <p><strong>2.3 Contraindications</strong><br>
Kadcyla is contraindicated in patients with a known hypersensitivity to Kadcyla or any of the excipients.</p>
- Atc Code
- L01XC14
- Atc Item Name
- xl 01 xc 14
- Pharma Manufacturer Name
- ROCHE SINGAPORE PTE. LTD.