following a second re-submission considered under the ultra-orphan and end of life process:
trastuzumab (Herceptin®) is accepted for restricted use within NHS Scotland.
Indication under review: in combination with capecitabine or fluorouracil and cisplatin for the treatment of patients with HER2 positive metastatic adenocarcinoma of the stomach or gastro-oesophageal junction who have not received prior anti-cancer treatment for their metastatic disease. It is indicated for use only in patients with metastatic gastric cancer whose tumours have HER2 overexpression as defined by IHC2+ and a confirmatory FISH+ result, or IHC 3+, as determined by an accurate and validated assay.
SMC restriction: for use in patients whose tumours have HER2 overexpression defined by immunohistochemistry (IHC) 3+ (“HER2 high expresser”).
The addition of trastuzumab to doublet chemotherapy improved overall and progression-free survival and tumour response.
This advice takes account of the views from a Patient and Clinician Engagement (PACE) meeting.
Download detailed advice201KB (PDF)
Medicine details
- Medicine name:
 - trastuzumab (Herceptin)
 - SMC ID:
 - 623/10
 - Indication:
 - in combination with capecitabine or fluorouracil and cisplatin for the treatment of patients with HER2 positive metastatic adenocarcinoma of the stomach or gastro-oesophageal junction who have not received prior anti-cancer treatment for their metastatic disease. It is indicated for use only in patients with metastatic gastric cancer whose tumours have HER2 overexpression as defined by IHC2+ and a confirmatory FISH+ result, or IHC 3+, as determined by an accurate and validated assay.
 - Pharmaceutical company
 - Roche
 - BNF chapter
 - Malignant disease and immunosuppression
 - Submission type
 - Resubmission
 - Status
 - Restricted
 - Date advice published
 - 12 October 2015