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methotrexate + carboplatin + trastuzumab
- Development stage
- Unknown
- Lead developer
- Roche
- Modality
- Monoclonal Antibodies → Antibody-Based Therapeutics, Small Molecules
- Administration
- Intra-arterial, Intravenous
01
Overview
This specialized chemo-immunotherapy regimen was developed at the OHSU Knight Cancer Institute specifically for treating brain metastases secondary to breast cancer. The protocol employs osmotic blood-brain barrier disruption (BBBD) using intra-arterial mannitol to transiently open the blood-brain barrier, thereby enhancing the delivery of methotrexate and carboplatin into the central nervous system. Methotrexate serves as an antifolate that inhibits dihydrofolate reductase, while carboplatin acts as a DNA alkylating agent to induce cell death in rapidly dividing tumor cells. In patients with HER2-positive breast cancer, the monoclonal antibody trastuzumab is administered concurrently to target the HER2 receptor. The regimen often includes sodium thiosulfate as a delayed systemic rescue agent to mitigate carboplatin-induced ototoxicity.
- Brand names
- HerceptinParaplatinTrexall
- Other names
- BBBD with Methotrexate, Carboplatin, and TrastuzumabOHSU BBBD protocol
02
Targets
DHFR (Dihydrofolate reductase)DNAERBB2 (Erb-b2 receptor tyrosine kinase 2)
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