CASE REPORT : A SEVERE INFUSION REACTION DURING THE FIRST DOSE OF INTRAVENOUSLY ADMINISTERED TRASTUZUMAB

Objective: To report a case of severe infusion reaction during the first dose of intravenously administered trastuzumab. Methods and Results: Here we present a case of a 53-year-old female patient (V. Y) with HER 2 pozitive breast cancer who, after completion of primary therapy (mastectomy, radiotherapy and chemotherapy) has developed hepatic and thoracic vertebrae metastatic formations. Due to this, the staff recommended trastuzumab (Herceptin) and capecitabine (Xeloda) for six months, but during the intravenously administered trastuzumab, the patient developed a severe infusion reaction manifested with hypertension (175/98 mm Hg), shortness of breath, cyanosis, pounding heart, panic attack, chills and fever. Trastuzumab is not associated with the adverse events that typically occur with chemotherapy, such as alopecia, myelosuppression, and severe nausea and vomiting. With the exception of hypersensitivity, which has been seen mainly and occasionally with the first infusion, cardiotoxicity (principally congestive heart failure) is the most important adverse effect of trastuzumab. Conclusions: Investigations of trastuzumab in the adjuvant setting require careful patient monitoring and stopping rules specified for hypersensitivity reactions and cardiotoxicity.