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Ado-Trastuzumab Emtansine use while Breastfeeding

Drugs containing Ado-Trastuzumab Emtansine: Kadcyla

Medically reviewed by Drugs.com. Last updated on May 16, 2021.

Ado-Trastuzumab Emtansine Levels and Effects while Breastfeeding

Summary of Use during Lactation

No information is available on the clinical use of ado-trastuzumab during breastfeeding. Because trastuzumab is a large protein molecule with a molecular weight of 145,531 Da, the amount in milk is likely to be very low. It is also likely to be partially destroyed in the infant's gastrointestinal tract and absorption by the infant is probably minimal. However, ado-trastuzumab emtansine also contains the small molecule cytotoxin, DM1. The manufacturer recommends avoiding breastfeeding during and for 7 months following ado-trastuzumab emtansine therapy.

Trastuzumab is a human immunoglobulin G1 (IgG1) kappa antibody. Holder pasteurization (62.5 degrees C for 30 minutes) decreases the concentration of endogenous immunoglobulin G by up to 79%.[1,2] A study of 67 colostrum samples that underwent Holder pasteurization found that IgG amounts decreased by 34 to 40%. Specific IgG subclasses decreased by different amounts, with IgG1 activity decreasing by about 37%.[3] None of the studies measured IgG activity.

Drug Levels

Maternal Levels. Relevant published information was not found as of the revision date.

Infant Levels. Relevant published information was not found as of the revision date.

Effects in Breastfed Infants

Relevant published information was not found as of the revision date.

Effects on Lactation and Breastmilk

Relevant published information was not found as of the revision date.

References

1.
Koenig A, de Albuquerque Diniz EM, Barbosa SF, et al. Immunologic factors in human milk: The effects of gestational age and pasteurization. J Hum Lact. 2005;21:439–43. [PubMed: 16280560]
2.
Adhisivam B, Vishnu Bhat B, Rao K, et al. Effect of Holder pasteurization on macronutrients and immunoglobulin profile of pooled donor human milk. J Matern Fetal Neonatal Med. 2019;32:3016–9. [PubMed: 29587541]
3.
Rodríguez-Camejo C, Puyol A, Fazio L, et al. Antibody profile of colostrum and the effect of processing in human milk banks: Implications in immunoregulatory properties. J Hum Lact. 2018;34:137–47. [PubMed: 28586632]

Substance Identification

Substance Name

Ado-Trastuzumab Emtansine

CAS Registry Number

1018448-65-1

Drug Class

Breast Feeding

Lactation

Antibodies, Monoclonal

Antineoplastic Agents

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Further information

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