Tablets from breast cancer

A tumor of the breast with signs of malignancy, indicates a cancer. This problem is relevant for women of all ages, since about 20% of cancerous tumors are in the mammary glands. Every year this pathology grows younger and spreads. Previously, the disease was detected in women older than 40 years, now there are cases of patients younger than 30 years. Proceed from this, the demand for pills from breast cancer is growing.

The tactics of treatment and the choice of drugs depend on the stage of the disease and the general health of the patient. Oncologists distinguish such types of tumors:

• ERTS-positive, that is, there are estrogen receptors in the neoplasm. The tumor quickly increases, as it receives regular replenishment from the hormone. Estrogen promotes the rapid growth and reproduction of cancer cells.
• ERTS-negative. In the second type of cancer, anti-estrogen drugs are used that block the receptors of the tumor. Thanks to this, the cancer slows down its growth. In pharmacology, such drugs are called selective modulators of estrogen receptors.

To date, there are several methods for treating breast cancer: radiation therapy, surgery, hormone therapy, chemotherapy and drug therapy. In most cases, these methods combine with each other to achieve a better result.

Consider two treatment methods, the use of which involves the use of tablets against cancer:

1. Chemotherapy

Preparations from this group damage malignant cells, disrupting its DNA. Thanks to this, the cells do not divide and die. This method has two types:

• Adjuvant chemotherapy - is used in the absence of a pronounced cancer process, that is, for the destruction of metastases.

• Non-adjuvant chemotherapy - is applied before the main therapy, for example, before the operation. It is aimed at reducing the size of the tumor. The effect of the drugs makes it possible to perform an organ-preserving operation and to determine the level of sensitivity of cancer cells to chemotherapy.

The procedure is carried out cyclically, giving patients tableted and injectable preparations. The main disadvantage of this treatment is a number of side effects: nausea, vomiting, diarrhea, pathological effects on the central nervous system.

2. Hormonotherapy

Used for hormone-dependent tumors, to eliminate metastases and prevent secondary cancer after therapy. Most often, patients are prescribed such drugs: blockers of hormonal receptors of malignant cells (Toremifene, Tamoxifen) and blockers of the synthesis of estrogens (Femara, Arimidex, Letrozol). Hormone therapy can cause complications, for example, the drug Tamoxifen provokes endometrial hyperplasia, exacerbation of varicose veins and other adverse reactions.

Chemotherapy and hormone therapy are two different in their effectiveness method. The doctor chooses the one that is most effective at the current stage of cancer, the prevalence of metastases and other features of the female body. So, hormonotherapy is effective in metastasizing to soft tissues and bones, and chemotherapy with metastases in the liver, lungs and aggressiveness of the pathological process.

It is simply impossible to choose pills from breast cancer independently. Only after complex diagnosis, determination of the stage of the disease, the location of the tumor and its size, it is possible to prescribe drugs. In this case, the tablets will not be the only method of treatment, rather they will act as an additional therapy.

Tamoxifen

An antiestrogenic drug with anti-tumor properties. Tamoxifen has a tablet form of release with an active substance - tamoxifen citrate. Auxiliary components are: calcium dihydrogen phosphate, lactose, silicon dioxide colloid, magnesium stearate, povidone and others.

The drug has estrogenic properties. Its effectiveness is based on the blocking of estrogens, and metabolites bind to the cytoplasmic hormone receptors in the tissues of the mammary glands, vagina, uterus, tumors with an increased estrogen content and anterior pituitary gland. Tablets do not stimulate the synthesis of DNA in the nucleus of malignant cells, but inhibit their division, causing regression and death.

After oral intake quickly absorbed, the maximum concentration in the blood plasma is observed for 4-7 hours (with a single dose). The level of binding to plasma proteins is 99%. Metabolized in the liver, excreted with feces and urine.

• Indications for use: breast cancer in women (estrogen-dependent, especially during menopause) and mammary glands in men. Suitable for the treatment of ovarian, endometrial, prostate, kidney, and melanoma, soft tissue sarcoma, with estrogen in the neoplasm. Assigned with resistance to other medicines.
• The way of application and dosage is individual for each patient and depends on the medical indications. The daily dose of 20-40 mg, the standard treatment regimen involves the use of 20 mg daily, for a long time. If during therapy there are signs of progression of the disease, then the drug is canceled.
• Contraindications: individual intolerance of components, pregnancy and breastfeeding. With special care is prescribed for patients with diabetes mellitus, ophthalmic diseases, kidney failure, thrombosis. And also with leukopenia and the use of indirect anticoagulants.
• Adverse reactions are associated with antiestrogenic effects and are manifested as paroxysmal sensations of the gift, itching in the genital area, weight gain and vaginal bleeding. In rare cases, there is swelling, nausea, vomiting, fatigue and depression, headaches and confusion, skin allergic reactions. Overdose has a similar symptomatology.

When using the drug, it is necessary to take into account the fact that pills increase the risk of pregnancy, which is contraindicated during treatment. Therefore, during therapy it is very important to use non-hormonal or mechanical contraceptives. During the treatment of cancer, women should undergo regular gynecological examinations. If there are spotting from the vagina or bleeding, then taking the pills is stopped.

Letromara

A non-steroidal aromatase inhibitor (an enzyme that synthesizes estrogens in the postmenopausal period). Letromara turns androgens, which are synthesized by the adrenal glands into estradiol and estrone. The drug lowers the concentration of estrogens by 75-95%. After taking, the tablets are quickly and completely absorbed from the digestive tract. The ingestion slows the rate of absorption, but does not change the degree of absorption. Bioavailability is 99%, while 60% of the drug binds to blood plasma proteins. Long-term treatment does not cause cumulation. Metabolism occurs with isoenzymes of cytochrome P450 - CYP 3A4. It is excreted in the form of metabolites with urine and feces.

• Indications for use: breast cancer (common) in postmenopause or after prolonged use of antiestrogens. It is prescribed for localized hormone-dependent cancer after surgical treatment and for preventive purposes.
• Dosing and Administration: 2.5 mg per day daily. Therapy is long, until the recurrence of the disease. The medication does not require dose adjustment for elderly patients or patients with impaired renal and hepatic function.
• Side effect: dizziness and headaches, muscle weakness, attacks of nausea and vomiting, diarrhea, swelling, vaginal spotting and bleeding. Also possible dermatological reactions - itching, rashes, alopecia and disorders of the endocrine system - increased sweating, decreased or increased body weight.
• Contraindications: intolerance of the components of the drug, pre-menopausal period, kidney and liver diseases, pregnancy and lactation, the age of patients under 18 years. During treatment, care must be taken when controlling machinery and vehicles, as there may be dizziness and headaches.

Anastrozole

An antineoplastic agent that inhibits the synthesis of estrogens. Anastrozole suppresses aromatase and prevents the transformation of androstenedione into estradiol. Therapeutic doses reduce estradiol by 80%, which is effective in estrogen-dependent tumors in the postmenopausal period. Does not possess estrogenic, progestagenic or adrogenic properties. Has a tablet form of release. The active substance is anastrozole, auxiliary components are: hypromellose, magnesium stearate, titanium dioxide, povidone-K30 and others.

• Indications for use: hormone-dependent breast cancer in the early stages and in the postmenopausal period, a common cancer, tumors resistant to tamoxifen. Dosage is calculated for each patient individually. With a standard schedule, 1 mg per day is prescribed, the course of treatment is prolonged.
• Side effects: asthenic syndrome, drowsiness, increased fatigue and anxiety, insomnia, dry mouth, abdominal pain, nausea and vomiting, dizziness and headaches, paresthesia, rhinitis, myalgia, alopecia, back pain and other negative reactions. Overdose is accompanied by similar symptoms. To eliminate these reactions, symptomatic therapy, absorption of absorbents and gastric lavage are indicated.
• Contraindications: intolerance to anastrozole and other drug components, use of tamoxifen, pregnancy and lactation, hepatic and renal failure, treatment with estrogen-containing medications, indications during the premenopause. When interacting with other drugs, you need to pay attention to the fact that estrogens and tamoxifen reduce the effectiveness of Anastrozole.

[1], [2], [3], [4]

Zoladeks

Pharmacological agent from the group of inhibitors of the synthesis of hormones that affect the synthesis of gonadotropins. Zoladex is a synthetically synthesized hormone drug. Its active ingredient is goserelin. The drug inhibits the pituitary synthesis of luteinizing and follicle-stimulating hormones. This causes a decrease in the level of testosterone and estradiol in the blood. Produced in capsules of 3.6 and 10.8 mg, each capsule is in a syringe applicator with an aluminum envelope.

• Indications for use: hormone-dependent breast cancer in women of reproductive age and with premenopause. It is prescribed for thinning of the endometrium before surgery, with endometriosis, malignant lesions of the prostate, fibroids of the uterus. Capsules are intended for subcutaneous injection into the anterior abdominal wall. The injection is done every 28 days, the standard course of therapy is 6 capsules.
• Side effects: vaginal bleeding, skin allergic reactions, amenorrhea, decreased libido, dizziness and headaches, decreased mood, mental disorders, paresthesia, hot flashes, heart failure, blood pressure jumps and much more. Signs of an overdose have a similar symptomatology. Symptomatic therapy is indicated for their elimination.
• Contraindications: hypersensitivity to the components of the drug, goserelin and its structural analogues. It is not used in pregnancy and lactation, for the treatment of patients of childhood. With special caution is prescribed with a tendency to obstruction of the ureters, IVF against the background of polycystic ovaries and compression lesions of the spine.

Melphalan

An anticancer agent whose action is based on damage to the DNA molecule of a cancer cell and the formation of defective forms of RNA and DNA stopping protein synthesis. Melphalan is active against passive tumor cells. Stimulates proliferative processes in tissues surrounding neoplasms. Produced in two forms: tablets for oral administration and injection.

• Indications for use: breast cancer, multiple myeloma, polycythemia, progressive neuroblastoma, soft tissue sarcoma of the extremities, cancer of the rectum and large intestine, malignant blood disorders.
• The drug is taken orally, intraperitoneally, by hyperthermic regional perfusion and intrapleural. Dosage is individual for each patient and depends on general indications. The average duration of treatment is from 1 year.
• Side effects: gastrointestinal bleeding, stomatitis, attacks of nausea and vomiting, diarrhea, cough and bronchospasm, vaginal bleeding, painful urination, swelling, skin allergic reactions, development of infections, fever.
• Contraindications: hypersensitivity to components, oppression of bone marrow function. With special care is used for arthritis, chicken pox, urolithiasis. And also with radiation or cytotoxic therapy.
• Overdose: attacks of nausea and vomiting, impaired consciousness, muscle paralysis and cramps, stomatitis, diarrhea. To eliminate these reactions, symptomatic therapy is indicated. If the overdose has a pronounced character, then hospitalization and monitoring of vital functions is required. Hemodialysis is ineffective.

Streptozocin

Antitumor drug with alkylating properties from the group of nitrosoureas. Streptozocin exerts a destructive effect on cancer cells, prevents their division and causes death.

• Indications for use: carcinoid tumor neoplasms, malignant pancreatic lesions (progressive metastatic or clinically expressed cancer). The dosage is individual for each patient and depends on the indications, the treatment regimen used and the severity of the side effects.
• Contraindications: chicken pox, herpes zoster, hypersensitivity to streptozotin, pregnancy and lactation, impaired renal and hepatic function. With special care appoint to patients with diabetes, acute infectious diseases and with previous treatment with cytotoxic drugs or radiation therapy.
• Side effects: nausea, vomiting and diarrhea, glycosuria, renal acidosis, in rare cases, leukopenia and thrombocytopenia, diabetic reactions, infections. To eliminate them, symptomatic therapy and withdrawal of the drug are indicated.

Thiotepa

Immunodepressive, antitumor agent from the pharmacological group of cytostatics. Thiotepa is a trifunctional alkylating compound from the group of nitrogen mustard gas. Its activity is associated with changes in DNA functions and effects on RNA. This leads to a disruption in the exchange of nucleic acids, blocks the biosynthesis of the protein and the processes of dividing cancer cells.

Has a carcinogenic and mutagenic effect. Prolonged use of the drug may cause the development of secondary malignant tumors and degenerative changes in the sex glands. This entails amenorrhea or azoospermia and other pathologies. The tablets undergo systemic absorption, the level of absorption depends on the dosage. Metabolizes in the liver, forming metabolites. It is excreted by the kidneys with urine.

• Indications for use: cancer of the breast, lungs, bladder. Effective in the treatment of pleural mesothelioma, with exudative pericarditis, peritonitis, malignant lesions of the meninges, with lymphogranulomatosis, lymphosarcoma, reticulosarcoma.
• The method of application and dose are individual for each patient. When breast cancer is taken at 15-30 mg 3 times a week, treatment is 14 days. Between each course there should be a break of 6-8 weeks.
• Contraindications: hypersensitivity to components, leukopenia, thrombocytopenia, cachexia and severe anemia, pregnancy and lactation. With special care is used for chicken pox, systemic infections, gout, urolithiasis, for the treatment of patients of children and the elderly.
• Adverse effects of the substance: gastrointestinal bleeding, nausea and vomiting, stomatitis, headaches and dizziness, swelling of the lower extremities, cough and swelling of the larynx, cystitis, back and joint pain, skin and local allergic reactions.
• Overdose: nausea, vomiting, bleeding, fever. To eliminate these reactions, symptomatic therapy is shown, in particularly severe cases, hospitalization and transfusion of blood components.

Chlorambucil

Effective drug, prescribed for the treatment of breast cancer. Chlorambucil has antitumor and immunosuppressive properties. After entering the body, it binds to the nucleoproteins of the cell nuclei, acting on the DNA chains of the tumor cells. Has a toxic effect on the dividing and non-dividing cells, oppresses the tumor and hematopoietic tissue. When administered orally, it is quickly and completely absorbed from the digestive tract, the binding to plasma proteins is 99%. It falls into metabolites, is excreted by the kidneys with urine.

• Indications for use: malignant tumors of the mammary glands, ovaries, chorioepithelioma of the uterus, myeloma, nephrotic syndrome, lymphogranulomatosis, chronic lymphocytic leukemia. Dosage is selected individually for each patient and adjusted during therapy on the basis of clinical effect.
• Side effects: bleeding of the gastrointestinal tract, nausea and vomiting, dysfunction of the liver, stomatitis, leukopenia, anemia, acute leukemia, hemorrhages, coughing and shortness of breath, difficulty urinating, tremor of limbs and muscle pains, skin allergic reactions, development of infections and fever.
• Contraindications: intolerance of the components of the drug and other alkylating medications, epilepsy, severe violations of the liver, leukopenia. With special caution is prescribed for oncological patients with chickenpox, shingles, with oppression of bone marrow function, with gout, urolithiasis and head injuries and convulsive disorders.
• Overdose: dysfunction of the central nervous system, epipriposition, increased adverse reactions. For treatment, symptomatic therapy and the use of broad-spectrum antibiotics are used. Hemodialysis is ineffective.

[5], [6], [7], [8]

Cyclophosphamide

Cytostatic agent, whose action is directed to the destruction of cancer cells. Cyclophosphamide is biotransformed in the liver, forming active metabolites with alkylating properties. These substances attack the nucleophilic centers of protein molecules of pathological cells, forming cross-links between DNA alleles and blocking the growth and multiplication of cancer cells. The drug has a wide range of antitumor activity. Its long-term use may cause the development of secondary malignant tumors.

After oral intake quickly absorbed, bioavailability is 75%. Binding to blood plasma proteins is low 12-14%. Biotransformiruetsya in the liver, forming active metabolites. Passes through the placental barrier and enters the breast milk. It is excreted in the urine in the form of metabolites and 10-25% unchanged.

• Indications for use: cancer of the breast, lung, ovaries, neck and body of the uterus, bladder, testicle, prostate. It is prescribed for neuroblastoma, angiosarcoma, lymphosarcoma, leukemia and lymphogranulomatosis, osteogenic sarcoma, Ewing's sarcoma, and also for autoimmune diseases (systemic lesions of connective tissue, nephrotic syndrome).
• The drug is used intraperitoneally and intrapleural. The choice of the method of administration and dosage depends on the chemotherapy regimen and general indications. Dosage is selected for each patient individually. The course dose of 80-140 mg with the subsequent transition to the supporting 10-20 mg twice a week.
• Contraindications: intolerance of drug components, severe renal dysfunction, leukopenia, thrombocytopenia, severe anemia, bone marrow hypoplasia, pregnancy and breastfeeding, thermal stages of cancer. With special care is used to treat patients younger than 18 years of age and senile.
• Side effects: stomatitis, nausea and vomiting, pain in the digestive tract and bleeding, jaundice, dry mouth. But most often patients complain of dizziness and headaches, bleeding and hemorrhages, shortness of breath, various disorders of the cardiovascular system, skin allergic reactions.
• Overdose: nausea and vomiting, fever, hemorrhagic cystitis, dilated cardiomyopathy syndrome. For treatment, symptomatic therapy is performed. In severe cases, hospitalization and monitoring of vital functions are indicated. If necessary, transfusion of blood components, the introduction of stimulants hematopoiesis and antibiotics.

[9], [10], [11], [12]

Gemcitabine

A drug used in malignant lesions of the breast and other organs. Gemcitabine contains the active substance - gemcitabine hydrochloride. Has a pronounced cytotoxic effect, kills cancer cells at the stage of DNA synthesis.

When injected rapidly spreads throughout the body. The maximum plasma concentration is reached within 5 minutes after the infusion. The half-life period depends on the patient's age and sex, and on the dosage used. As a rule, it takes from 40-90 minutes to 5-11 hours from the moment of introduction. Metabolizes in the liver, kidneys, other organs and tissues, forming metabolic compounds. It is excreted in the urine.

• Indications for use: a comprehensive treatment of metastatic or locally advanced breast cancer (may be prescribed in combination with Paclitaxel and Anthracycline). Tumor lesions of the bladder, metastatic pancreatic adenocarcinoma, metastatic non-small cell lung cancer, epithelial ovarian cancer.
• Gemcitabine is used only for medical purposes. In combination with breast cancer, combined therapy is provided. The recommended dosage is 1250 mg per m2 of the patient's body on days 1 and 8 of the treatment with a cycle of 21 days. The drug is combined with Paclitaxel 175 mg per m2 on the first day of the 21 cycle. The drug is administered intravenously drops for 180 minutes. With each subsequent cycle, the dosage is reduced.
• Side effects: nausea and vomiting, increased liver transaminases and alkaline phosphatase, shortness of breath, allergic skin rash, itching, hematuria. With combined therapy, neutropenia and anemia are possible. When an overdose appears similar symptoms. There is no antidote, blood transfusion and other methods of symptomatic therapy are used for treatment.
• Contraindications: hypersensitivity to the components of the drug, pregnancy and breastfeeding.

Tegafur

Cytostatic agent, blocks the synthesis of DNA and thymidylate synthetase, makes cancer cells defective, destroying them. Tegafur has antitumor, analgesic and anti-inflammatory effects. Large doses of the drug depress hemopoiesis. When administered orally, it is rapidly absorbed from the digestive tract, the absorption is incomplete because of the first passage through the liver. It is excreted in urine and feces.

• Indications for use: malignant tumors of the breast, liver, stomach, bladder, prostate, head and skin, uterus, ovaries. Effective with skin lymphoma, phonophoresis and diffuse neurodermatitis.
• Dosage and route of administration: inside 20-30 mg / kg 2 times a day with an interval of 12 hours. The course of therapy lasts 14 days, repeated is carried out after 1.5-2 months. During treatment requires careful care of the oral cavity and vitamin therapy.
• Contraindications: individual intolerance of the components of the drug, terminal stages of cancer, pronounced changes in blood composition, anemia, oppression of bone marrow hematopoiesis, peptic ulcer diseases of the stomach and duodenum. It is not used during pregnancy and lactation.
• Side effects: confusion, increased lacrimation, thrombocytopenia and leukopenia, myocardial infarction, sore throat, dryness, itching and flaky skin, bleeding in the digestive tract. To resolve them, symptomatic therapy or drug cancellation is indicated.

Vinblastine

Chemotherapeutic antitumor medication. Vinblastine contains alkaloids of plant origin. It blocks metaphases of cellular mitosis by binding to microtubules. Active components of the drug selectively inhibit the synthesis of DNA and RNA, inhibiting the enzyme RNA polymerase.

It is available in the form of a lyophilized powder for the preparation of an injection solution of 5 and 10 grams. The kit contains 5 and 10 ml ampoules of the solvent, respectively. After intravenous administration quickly spreads through the body, does not penetrate the blood-brain barrier. Biotransformiruetsya in the liver, forming active metabolites, is excreted by the intestine. The elimination half-life is 25 hours.

• Indications for use: malignant neoplasms of various etiology and localization, including non-Hodgkin's lymphomas, testicular cancer, chronic leukemia and Hodgkin's disease. The standard dose of the drug is 0.1 mg / kg, injections are administered once a week. If necessary, the dosage can be increased to 0.5 mg / kg. During the treatment it is necessary to control the level of leukocytes in the blood and the level of uric acid.
• Contraindications: intolerance of the components of the agent, viral and bacterial infections. With special care is assigned to patients with recent radiation or chemotherapy, as well as with leukopenia, severe liver damage and thrombocytopenia. The use of Vinblastine for pregnant women is possible in the event that the potential benefit to the mother is higher than the risks to the fetus.
• Side effects: alopecia, leukopenia, muscle weakness and pain, attacks of nausea and vomiting, stomatitis, thrombocytopenia. It is also possible to develop gastric bleeding and hemorrhagic colitis. The drug can have a neurotoxic effect, causing double vision, depressive disorders, headaches.
• Signs of an overdose are similar to side effects. Their severity and intensity depends on the dose taken. There is no specific antidote, therefore, symptomatic therapy is performed. At the same time, it is necessary to monitor the blood condition and, in severe cases, to carry out its transfusion.

Vincristine

Pharmacological agent used for the treatment of malignant neoplasms. Vincristine is released in ampoules of 0.5 mg with a solvent. It is used for the complex therapy of acute leukemia, lymphosarcoma, Ewing's sarcoma and other malignant pathologies. The drug is administered intravenously at intervals of 7 days. The dosage is individual for each patient. The standard dose is 0.4-1.4 mg / m2 from the patient's body surface. During the procedure, you should avoid getting medication in the eyes and surrounding tissues, as this can provoke a strong irritant effect and necrosis of the tissues.

It is contraindicated to dissolve in one volume with Furosemide solution, since a precipitate is formed. Elevated doses can trigger such side effects: limb numbness and muscle pain, hair loss, dizziness, weight loss, fever, leukopenia, nausea and vomiting. The frequency of side effects depends on the total dose and duration of treatment.

Vinorelbine

Antitumoral injection means, issued in vials of 1 and 5 ml. Vinorelbine contains the active substance - vinorelbine ditartrate. After administration suppresses the division of cancer cells, blocks their further multiplication, causing death. It is used for various malignant diseases, including lung cancer. The drug is administered only intravenously. If during the procedure the substance has got into the surrounding tissues, this causes their necrosis. The dosage is individual for each patient.

Contraindicated to use in severe violations of liver function, for pregnant women and lactation. It is not applied simultaneously with X-ray therapy, which seizes the shoulder area. The main side effects: anemia, muscle spasms, paresthesia, intestinal obstruction, attacks of nausea and vomiting, difficulty breathing bronchospasm.

Karubicin

Antitumor drug from the pharmacological group of anthracycline antibiotics. Carubicin has an action mechanism associated with DNA damage in the S phase of mitosis. It is used for soft tissue sarcoma, neuroblastoma, Ewing's sarcoma, chorionepithelioma. Dosage depends on the stage of the disease, the state of the patient's hematopoiesis system and the prescribed therapy regimen.

Contraindicated to use in severe cardiovascular diseases, violations of the liver and kidneys, during pregnancy and lactation, with hypersensitivity to the components of the drug and when the number of leukocytes is less than 4000 / μl, and platelets below 100,000 / μL. Frequent adverse reactions: leukopenia, pain in the heart, heart failure, nausea and vomiting, nephropathy, lowering blood pressure, alopecia, gouty arthritis.

Fotretamin

Alkaloid, an ethyleneimine derivative. Fotretamine depresses granulocytopoiesis, tromocytopoiesis and erythrocytopoiesis. Reduces the size of the lymphatic and peripheral nodes of the liver and spleen. Does not have an antitumor effect on the intrathoracic lymph nodes. Restores the normal level of leukocytes in the peripheral blood within a month.

• Indications for use: erythremia, lymphocytic leukemia, ovarian cancer, reticulosarcoma, fungal mycosis, angiopathy of Kaposi. The agent is administered intravenously, intraperitoneally and intramuscularly, dissolving 10 ml of isotonic sodium chloride solution. Dosage and duration of treatment is determined by the doctor.
• Contraindications: hypersensitivity to the components of the drug, leukopenia, terminal stage of cancer, kidney and liver diseases.
• Side effects: anemia, decreased appetite, headaches, nausea, lakopenia, thrombopenia. With the development of these reactions, blood transfusion is performed, B vitamins and leukopoiesis stimulants are prescribed.

Pertuzumab

Effective drug used in cancerous lesions of the body. Pertuzumab is produced by recombinant DNA technology. It interacts with the extracellular subdomain, blocking the growth factor receptors and ligand-dependent heterodimerization of HER2 with other proteins of the HER family. The monoagent inhibits the proliferation of cancer cells.

• Indications for use: breast cancer (metastatic, local-recurring) with tumor overexpression of HER2. In most cases, it is used in combination with docetaxel and trastuzumab, provided that such therapy has not previously been performed and there is no progression of the disease after adjuvant treatment.
• Pertuzumab is administered intravenously by drip or jet. Before the start of treatment, the tumor expression of HER2 is tested. The standard dose is 840 mg in the form of an hourly-drop infusion. The procedure is carried out every three weeks.
• Contraindications: pregnancy and lactation, the age of patients under 18 years of age, cardiovascular disorders, impaired liver function. With special care is used with previous treatment with trastuzumab, anthracyclines or radiation therapy.
• Side effects: hypersensitivity reactions, neutropenia, leukopenia, decreased appetite, insomnia, increased tearing, congestive heart failure, shortness of breath, nausea, vomiting and constipation, stomatitis, muscle pain, myalgia, fatigue, puffiness, secondary infections.
• Overdose on the symptomatology is similar to collateral actions. Symptomatic therapy is indicated for its elimination. In particularly severe cases, hospitalization and blood transfusion are required.

Herceptin

Drug of humanized recombinant DNA (derived from monoclonal antibodies). Herceptin contains an active substance that inhibits the proliferation of neoplastic cells with overexpression of HER2. Hyperexpression of HER2 is associated with a high rate of development of primary breast cancer and common stomach tumors. Available in the form of lyophilizate 150 and 440 mg, with each bottle comes 20 ml of solvent.

• Indications for use: metastatic breast cancer with overexpression of HER2 tumor cells and its early stages, common adenocarcinoma of the stomach and esophageal-gastric junction. The drug can be used as a monotherapy, and in combination with Paclitaxel, Docetaxel and other antitumour agents.
• Before starting treatment, it is necessary to check for the expression of HER2 by the tumor. The drug provides intravenous drip introduction. When breast cancer is used at 4 mg / kg as a loading dosage and 2 mg / kg as a supporting. Infusions are carried out once a week. With combined therapy, the procedure is carried out once every 21 days. The number of cycles and the duration of treatment are determined by the attending physician, individually for each patient.
• Contraindications: pregnancy and breastfeeding, children of childhood, hypersensitivity to trastuzumab and other ingredients of the drug, severe shortness of breath (caused by metastases in the lungs or requiring oxygen therapy). With caution, the drug is prescribed for angina pectoris, hypertension, myocardial insufficiency.
• Side effects: pneumonia, cystitis, sinusitis, thrombocytopenia, neutropenic sepsis, dry mouth, nausea, vomiting and constipation, angioedema, urinary tract infections, sudden weight loss, limb tremor, muscle pains, skin hypersensitivity reactions, dizziness and headaches , insomnia, loss of sensation.
• The drug does not cause symptoms of an overdose. It is contraindicated to mix Herceptin with other medicines. Has a chemical incompatibility with a solution of dextrose, and when used with anthracyclines increases the risk of cardiotoxicity.