title: A case report of trastuzumab dose in gastric cancer.
abstract: BACKGROUND
  Trastuzumab (Herceptin®, F. Hoffman-La Roche) is now approved for the treatment of metastatic HER2-positive gastric cancer based on the improved survival observed on the phase III Trastuzumab for Gastric Adenocarcinoma (ToGA) study. Standard dosing of trastuzumab is currently extrapolated from breast cancer data: a 3-week schedule (8 mg/kg load, 6 mg/kg q 3 weeks) or a weekly schedule (4 mg/kg load, 2 mg/kg q week).
  
  
  METHODS
  Our case study examines an HER2-positive metastatic gastric cancer patient that required a higher than currently recommended standard dose of trastuzumab to achieve treatment response.
  
  
  CONCLUSIONS
  Several mechanisms may explain these findings and include higher clearance of trastuzumab, higher tumor burden, and pharmacologic resistance in metastatic gastric cancer versus breast cancer. The question of trastuzumab dosing in gastric cancer is currently being evaluated in a phase III clinical trial.
authors.affiliation: Department of Medicine and Center for Advanced Digestive Care, New York-Presbyterian Hospital, Weill Cornell Medical Center, New York, NY 10021, USA.
authors.forename: Chrisann
authors.initials: C
authors.lastname: Kyi
authors.forename: Manish A
authors.initials: MA
authors.lastname: Shah
keywords: Trastuzumab; metastatic gastric cancer; pharmacokinetics