Tucatinib: Effective Treatment for HER2-Positive Breast Cancer

Summary or Key Points

Tucatinib is a targeted cancer therapy used to treat certain cancers, including HER2-positive breast cancer and other metastatic cancers. It works by blocking a protein that promotes cancer cell growth. Tucatinib is typically combined with other treatments. Always consult your healthcare provider before starting or adjusting any medication. You can also consult one of our providers through telemedicine for personalized care.

Names of Medication

US Brand Name: Tukysa

Generic Name: Tucatinib

The generic name refers to the chemical composition of the drug, while the brand name is assigned by the manufacturer. In this case, Tucatinib is the generic name.

Pharmacologic Category

HER2 Tyrosine Kinase Inhibitor

Other medications in this category include:

1. Lapatinib (Tykerb)
2. Neratinib (Nerlynx)

Dosing

Tucatinib is used to treat various cancers in adults. Dosage and treatment plans may vary based on the type of cancer and overall health. Always follow your doctor’s instructions and consult them before making any changes to your medication. If you need to discuss your treatment plan, our telemedicine providers are available to assist.

Breast Cancer (HER2-Positive, Metastatic)

Dosage: 300 mg orally twice daily

Frequency: Taken daily

Length of Treatment: Until disease progression or unacceptable side effects occur

Colorectal Cancer (HER2-Positive, Metastatic)

Dosage: 300 mg orally twice daily

Frequency: Taken daily

Length of Treatment: Until disease progression or unacceptable side effects occur

Other Cancers (Including Gastric, Esophageal, Pancreatic, Lung, Head and Neck, Biliary Tract)

Tucatinib may be used off-label for other HER2-positive cancers. The typical dosage is 300 mg orally twice daily, but this may vary. Always consult your healthcare provider for the most appropriate treatment plan for your specific condition.

Dosage Forms and Strengths

1. Tablet: 50 mg
2. Tablet: 150 mg

Administration Instructions

Tucatinib should be taken orally, with or without food. Swallow the tablets whole; do not crush, chew, or split them. If you miss a dose, take it as soon as you remember, unless it is close to your next dose. Do not take two doses at the same time. Always follow your healthcare provider’s instructions for taking this medication.

Adverse Reactions and Side Effects

Like all medications, Tucatinib may cause side effects. Some are common, while others are rare but serious. If you experience any side effects, contact your healthcare provider immediately. You can also schedule a telemedicine appointment with one of our providers to discuss any concerns.

1. Diarrhea (Very Common): Loose or watery stools. This frequent side effect can often be managed with over-the-counter medications or dietary adjustments.
2. Nausea and Vomiting (Common): Feeling sick or vomiting. Your doctor may prescribe medications to help control these symptoms.
3. Fatigue (Common): Feeling unusually tired or weak. Rest and proper nutrition can help alleviate this.
4. Hand-Foot Syndrome (Less Common): Redness, swelling, and pain on the palms or soles. This can be managed with moisturizing creams and by avoiding heat or friction.
5. Liver Toxicity (Rare but Serious): Symptoms include yellowing of the skin or eyes, dark urine, or pain in the upper right abdomen. Contact your doctor immediately if you experience these symptoms.

Contraindications

A contraindication is a specific condition where a medication should not be used because it may cause harm. It is important to know if any of these apply to you before starting Tucatinib. Always discuss your medical history with your healthcare provider to ensure Tucatinib is safe for you.

1. Severe liver disease: Tucatinib is processed by the liver. If you have severe liver disease, taking Tucatinib could lead to further liver damage or toxicity, as your body may not process the drug properly.
2. Allergic reaction to Tucatinib or its ingredients: If you have had an allergic reaction to Tucatinib, taking it again could cause serious side effects, including life-threatening anaphylaxis.
3. Pregnancy: Tucatinib can harm an unborn baby. It is contraindicated during pregnancy unless the potential benefits outweigh the risks. Women of childbearing age should use effective contraception while taking Tucatinib.

Drug to Drug Interactions

Tucatinib can interact with other medications, which may affect its efficacy or increase the risk of side effects. Be sure to inform your healthcare provider about all medications you are taking, including over-the-counter drugs, vitamins, and supplements. Below are some medications that may interact with Tucatinib:

1. Rifampin (Rifadin): This antibiotic can decrease the effectiveness of Tucatinib by speeding up its breakdown in the liver.
2. Phenytoin (Dilantin): Used to control seizures, Phenytoin can reduce Tucatinib levels in your body, making it less effective.
3. St. John’s Wort: This herbal supplement can reduce Tucatinib’s effectiveness by increasing its breakdown in the liver.
4. Ketoconazole (Nizoral): This antifungal medication can increase Tucatinib levels in your body, raising the risk of side effects.
5. Warfarin (Coumadin): Tucatinib may increase the effects of blood thinners like Warfarin, leading to a higher risk of bleeding.

Tucatinib in Pregnancy

Is it safe to take Tucatinib when pregnant?

No, Tucatinib is not considered safe during pregnancy. It can harm an unborn baby, potentially leading to birth defects or miscarriage. If you are pregnant or planning to become pregnant, it is important to avoid taking Tucatinib. Women of childbearing age should use effective contraception during treatment and for at least one week after the final dose. If you become pregnant while taking Tucatinib, contact your healthcare provider immediately to discuss your options.

Tucatinib while Breastfeeding

Is it safe to take Tucatinib while breastfeeding?

It is not recommended to take Tucatinib while breastfeeding. Although there is no specific data on whether Tucatinib passes into breast milk, the potential for serious side effects in a nursing infant means breastfeeding should be avoided during treatment and for at least one week after the last dose. If you are breastfeeding or planning to breastfeed, consult your healthcare provider to explore alternative options.

Estimated Cost of Tucatinib

The estimated cost of a 30-day supply of Tucatinib without insurance, using a GoodRX coupon, ranges from $17,000 to $18,000. Prices may vary depending on the pharmacy and location. If the cost is a concern, speak with your healthcare provider or pharmacist about financial assistance programs or alternative treatment options that may be available to you.

Possible Alternatives to Tucatinib

If Tucatinib is not suitable for you, other treatments and lifestyle changes may help manage your condition. Always discuss any changes to your treatment plan with your healthcare provider. You can also schedule an appointment with one of our providers through telemedicine to explore your options.

Breast Cancer Treatment Alternatives

Breast cancer: Alternatives may include other targeted therapies such as Trastuzumab (Herceptin), chemotherapy, hormone therapy, or radiation. Additionally, lifestyle changes like maintaining a healthy weight, engaging in regular physical activity, and limiting alcohol consumption may help manage your risk.

HER2-Positive Breast Cancer Treatment Options

HER2-positive breast cancer: Other targeted therapies, such as Pertuzumab (Perjeta) or Lapatinib (Tykerb), may be considered. Discuss these options with your healthcare provider to determine the best course of action for your specific case.

Metastatic Breast Cancer Treatment

Metastatic breast cancer: Treatment options may include chemotherapy, hormone therapy, or immunotherapy. Palliative care, which focuses on managing symptoms and improving quality of life, is also an important consideration.

Colorectal Cancer Treatment Alternatives

Colorectal cancer: Alternatives may include chemotherapy, targeted therapies such as Bevacizumab (Avastin), or immunotherapy. In addition, dietary changes and regular screenings can play a role in managing the disease.

Gastric Cancer Treatment Options

Gastric cancer: Common treatments include surgery, chemotherapy, and radiation. Targeted therapies, such as Ramucirumab (Cyramza), may also be part of the treatment plan.

Esophageal Cancer Treatment Alternatives

Esophageal cancer: Surgery, chemotherapy, and radiation are typical treatments. Lifestyle changes, such as quitting smoking and reducing alcohol intake, can also support treatment and improve outcomes.

Pancreatic Cancer Treatment Options

Pancreatic cancer: Treatment options include surgery, chemotherapy, and radiation. Maintaining a healthy diet and managing conditions like diabetes may also contribute to better outcomes.

Lung Cancer Treatment Alternatives

Lung cancer: Alternatives include chemotherapy, targeted therapy, immunotherapy, and radiation. Quitting smoking is one of the most important lifestyle changes for managing lung cancer and improving overall health.

Head and Neck Cancer Treatment Options

Head and neck cancer: Surgery, radiation, and chemotherapy are common treatments. Avoiding tobacco and alcohol can help reduce the risk of recurrence and improve long-term outcomes.

Biliary Tract Cancer Treatment Alternatives

Biliary tract cancer: Surgery, chemotherapy, and radiation are typical treatments. Maintaining a healthy diet and managing liver health may also support treatment and improve overall well-being.

Recent Updates on Tucatinib Research

Recent studies have shown promising results for Tucatinib, particularly when combined with other therapies for treating HER2-positive breast cancer, especially in patients with brain metastases. Ongoing clinical trials are also exploring Tucatinib’s potential in treating other HER2-positive cancers, including colorectal and gastric cancers. Researchers are investigating whether combining Tucatinib with immunotherapy could further improve outcomes for patients with advanced cancers. As research continues, new treatment options and combinations may become available, offering hope for patients facing difficult-to-treat cancers.

James Kingsley

Learn More