Dilutants ?

[Steph N.]

Statement was:
"possible reactions to the dilutant used to reconstitute Herceptin before infusion. Apparently it contains benzyl alcolhol as a preservative and some have developed a sensitivity to it, so that would be my first guess. If that's the case, saline can be used instead."

I find this VERY interesting. I will have to find out what they are using at my cancer center to mix my Herceptin. So far in 2 years and 2 months no problems for me, but I want to know.
What I DO know is that the nurse assigned to me for my infusions does not order the parmacy to mix the drugs until they see that I am checked in at the front desk. In that case I wonder why a preservative would be needed, as they start the infusion within 5-15 minutes of picking up from the pharmacy which is next to the infusion suite.

I am interested in this in light of the recent posts on Abraxane, the new version of Taxol, which is not mixed with the same, toxic diluntant as Taxol.
So, the question is: Is it the herceptin or the dilutant that can cause the heart problems??? Would appreciate any insight.

[jessica]

steph-
it is very common for people to have sensitivities to the perservative a drug is combined with-whether that drug is herceptin or anything else.also, "preservative" is the compound or suspension (the vehicle) that carries the drug(herceptin, taxol, whatever) and protects the drug's integrity when introduced in the body, not necessarily "preserving" it for the long term .have you ever read the ingredients on a bottle of cough syrup, for example?there will be a list of "active ingredients" like the cough suppressant, decongestant, etc., then there will be a list of the "inactive ingredients".preservatives are inactive ingredients.
I was following the development of Abraxane when it was in its early clinical research and it is essentially the same old taxane, only in a nanoparticle suspension that is better able to penetrate cancer cells more effectively, so that more drug gets INSIDE the cell to destroy it.
As far as Herceptin & cardio toxicity, the way I understand it is the only other place in the body that her2 receptors exist other than her2+ tumor cells is some cardiac cells.so the herceptin suppresses the her2 receptors on tumor cells AND heart cells, that could lead to cardiac function suppression.
Hope this info is helpful...I'm a clinical researcher and a bit of a science geek!However it has served me very well during my diagnosis & treatment!!
Keep the faith & take good care!

[Steph N]

Thanks Jessica - you made a lot of sense.
I had read about the heart containing some her-2 receptors, but did not put that together with the reason for possible loss of function.
I do find that I am having a long climb back from all the chemo in regaining some stamina. I still get short of breath and have to limit my activities and I am 20 months off chemo and still get herceptin every three weeks on the dot.
I see the use of "preservative" is not the same as keeping a loaf of bread from getting moldy!!!
Cheers!