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Trastuzumab is used to treat breast cancer. It is effective against tumors that overexpress the HER2/neu protien. As part of chemotherapy regimen for adjuvant treatment of lymph-node positive, HER2/neu positive cancer.

Herceptin (generic name: trastuzumab) is not a chemo drug, it is a targeted therapy anticancer drug.
Herceptin contains one active ingredient, trastuzumab, and is given as an intravenous (IV) infusion slowly into a vein. Herceptin Hylecta contains two active ingredients, trastuzumab and hyaluronidase-oysk, and is given as a subcutaneous injection, which is an injection that goes under the skin.

The introduction of herceptin (Trastuzumab) into clinical practice for the treatment of breast cancer marks a major advance in the use of monoclonal antibody cancer therapy. Herceptin is a humanized antibody directed against the HER-2 antigen that is overexpressed on the tumor cell surface in approximately 25% of breast cancer patients. HER-2/neu/erbB2 overexpression marks an aggressive estrogen receptor–negative form of breast cancer. Therefore, a therapeutic agent selective for this target is particularly valuable. Herceptin is administered by intravenous infusion and in conjunction with paclitaxel can extend survival in patients with HER-2/neu/erbB2 overexpressing metastatic breast cancer.Herceptin use is associated with infusion- related hypotension, flushing and bronchoconstriction, and skin rash but no bone marrow toxicity. Herceptin appears to sensitize patients to cardiotoxicity, an important concern in patients also receiving doxorubicin.

Trastuzumab is a monoclonal antibody against human epidermal growth factor receptor 2 (HER2). Trastuzumab binds to an extracellular domain of this receptor and inhibits HER2 homodimerization, thereby preventing HER2-mediated signaling. It is also thought to facilitate antibody-dependent cellular cytotoxicity, leading to the death of cells that express HER2. Its mechanism differs slightly from that of the newer agent pertuzumab; the latter inhibits hetero-dimerization of HER2 with HER3, a related growth factor receptor. Trastuzumab has been shown to bind three distinct regions of domain IV of the HER2 extracellular domain through electrostatic and hydrophobic bindings[1].

[1] Hamid Maadi. “Trastuzumab Mechanism of Action; 20 Years of Research to Unravel a Dilemma.” Cancers (2021).