ION Breast Cancer Clinical Pathways - ION Solutions

Herceptin (Trastuzumab) Taxotere (Docetaxel) Paraplatin (Carboplatin) EP=Moderate;FN˃20%Trastuzumab 6mg/kg D1 (or weekly equivalent)Docetaxel 75mg/m2 D1 (D2 Cycle 1 only)Carboplatin AUC 6 D1 (D2 Cycle 1 only)q 21 Day Cycle x 6 CyclesThen continue:Trastuzumab 6mg/kg D1q 21 Day Cycle to complete 1 year of therapy>> JNatlCancerInst2004May19;96(10):739-49Tykerb (Lapatinib)Lapatinib 1250mg PO q DNote: 3 rd line or greater with cytotoxic chemotherapy>> Package InsertFemara (Letrozole) Tykerb (Lapatinib)Letrozole 2.5mg PO q DLapatinib 1500mg PO q D>> J Clin Onc 27: 5538-46, 2009Perjeta (Pertuzumab) Herceptin (Trastuzumab) Taxotere (Docetaxel) EP=Low;FN˃20%Pertuzumab 840mg D1 (Cycle 1 only)420mgD1Trastuzumab 8mg/kg D1 (Cycle 1 only)6mg/kgD1Docetaxel 75mg/m2 D1q 21 Day CycleNote: First line only>> FDA LabelClinical Trial:Screen patient for clinical trial. Check www.clinicaltrials.gov for available trials.Best Supportive Care and/or Hospice:Consider supportive care options and Hospice when appropriate.Note: Herceptin (Trastuzumab) can be used with any accepted breast cancerchemotherapy except anthracycline and appropriate to continue until diseaseprogression.Page 14 of 39© 2013 by ION Solutions. All rights reserved