natgillin/translations-raw huggingface dataset:
At the time of a safety update after a median of 3.5 - 3.8 years follow up, an analysis of DFS reconfirms the magnitude of the benefit shown in the definitive analysis of DFS. 
U vrijeme kontrole sigurnosti primjene nakon medijana praćenja od 3,5 - 3,8 godina, analiza preživljenja bez bolesti ponovno je potvrdila značajnu korist prikazanu u konačnoj analizi preživljenja bez bolesti.
What you need to know before you use Herzuma 
Što morate znati prije nego počnete primati lijek Herzuma
If possible, physicians should avoid anthracycline-based therapy for up to 7 months after stopping Herzuma. 
Ako je moguće, uputno je izbjegavati primjenu antraciklinske terapije do 7 mjeseci nakon prestanka primjene lijeka Herzuma.
If diluted aseptically, it may be stored for 24 hours (do not store above 30ºC). 
Ako je otopina za infuziju pripravljana u aseptičkim uvjetima, može se čuvati 24 sata (ne čuvati na temperaturi iznad 30°C).
Combination treatment with trastuzumab and anastrozole 
Kombinirano liječenje trastuzumabom i anastrozolom
Post-hoc exploratory analysis with DFS and symptomatic cardiac events Long term follow-up hazard ratios (95% CI) 
Post-hoc eksplorativna analiza s preživljenjem bez bolesti i simptomatskim srčanim događajima Dugoročno praćenje Omjeri hazarda (95% CI)
Patients treated with Herzuma are at increased risk for developing CHF (New York Heart Association [NYHA] Class II - IV) or asymptomatic cardiac dysfunction. 
U bolesnika liječenih lijekom Herzuma postoji povećan rizik od razvoja kongestivnog zatajenja srca (engl. congestive heart failure, CHF) (klase II - IV prema New York Heart Association [NYHA]) ili asimptomatske disfunkcije srca.
Risk factors for a cardiac event identified in four large adjuvant studies included advanced age (> 50 years), low LVEF (< 55%) at baseline, prior to or following the initiation of paclitaxel treatment, decline in LVEF by 10 - 15 points, and prior or concurrent use of anti-hypertensive medicinal products. 
Faktori rizika za srčani događaj utvrđeni u četiri velika ispitivanja adjuvantnog liječenja uključivali su stariju dob (> 50 godina), nizak LVEF (< 55%) na početku liječenja, prije ili nakon početka liječenja paklitakselom, pad LVEF-a za 10 - 15 bodova te prethodnu ili istodobnu primjenu antihipertenziva.
Herzuma treatment should only be initiated by a physician experienced in the administration of cytotoxic chemotherapy (see section 4.4), and should be administered by a healthcare professional only. 
Liječenje lijekom Herzuma smije započeti samo liječnik s iskustvom u primjeni citotoksične kemoterapije (vidjeti dio 4.4), a lijek smije primijeniti samo zdravstveni radnik.
An absolute benefit of 13 percentage points in favour of the trastuzumab arm was estimated in terms of 3-year event-free survival rate (65% versus 52%). 
Za skupinu koja je primala trastuzumab procijenjena je apsolutna korist od 13 postotnih bodova za stopu trogodišnjeg preživljenja bez štetnih događaja (65% naspram 52%).
Herzuma contains the active substance trastuzumab, which is a monoclonal antibody. 
Lijek Herzuma sadrži djelatnu tvar trastuzumab, koji je monoklonsko protutijelo.
In 3 pivotal clinical trials of adjuvant trastuzumab given in combination with chemotherapy, the incidence of grade 3/4 cardiac dysfunction (specifically symptomatic Congestive Heart Failure) was similar in patients who were administered chemotherapy alone (i.e. did not receive trastuzumab) and in patients who were administered trastuzumab sequentially after a taxane (0.3 - 0.4%). 
U 3 pivotalna klinička ispitivanja adjuvantne primjene trastuzumaba u kombinaciji s kemoterapijom, incidencija disfunkcije srca stupnja 3/4 (osobito simptomatsko kongestivno zatajenje srca) je bila slična u bolesnika koji su primili samo kemoterapiju (dakle, nisu primili trastuzumab) i u bolesnika koji su primili trastuzumab nakon taksana (0,3 - 0,4%).
A volume overage of 4% ensures that the labelled dose of 420 mg can be withdrawn from each vial. 
Višak volumena od 4% jamči da se naznačena doza od 420 mg može izvući iz svake bočice.
More patients experienced at least one grade 3 or 4 adverse event in the 2-year treatment arm (20.4%) compared with the 1-year treatment arm (16.3%). 
Barem jedan štetan događaj stupnja 3 ili 4 pojavio se u više bolesnika u skupini liječenoj tijekom 2 godine (20,4%) u usporedbi sa skupinom liječenom tijekom 1 godine (16,3%).
In a method comparison study (study D008548), a high degree of concordance (> 95%) was observed for SISH and FISH techniques for the detection of HER2 gene amplification in gastric cancer patients. 
U ispitivanju uspoređivanja metoda (ispitivanje D008548) u bolesnika s rakom želuca ustanovljen je visok stupanj podudarnosti (> 95%) za SISH i FISH metode utvrđivanja genske amplifikacije HER2.
In Study BO16348, after a median follow-up of 8 years the incidence of severe CHF (NYHA Class III & IV) in the trastuzumab 1 year treatment arm was 0.8%, and the rate of mild symptomatic and asymptomatic left ventricular dysfunction was 4.6%. 
U ispitivanju BO16348, nakon medijana praćenja od 8 godina, incidencija teškog kongestivnog zatajenja srca (NYHA klase III i IV) u skupini liječenoj 1 godinu trastuzumabom iznosila je 0,8%, dok je stopa blage simptomatske i asimptomatske disfunkcije lijeve klijetke iznosila 4,6%.
In BCIRG 006 study, 213/1075 patients in the DCarbH (TCH) arm, 221/1074 patients in the AC→DH (AC→TH) arm, and 217/1073 in the AC→D (AC→T) arm had a Karnofsky performance status ≤ 90 (either 80 or 90). 
U ispitivanju BCIRG 006 je 213/1075 bolesnica u skupini DCarbH (TCH), 221/1074 bolesnica u skupini AC→DH (AC→TH) i 217/1073 bolesnica u skupini AC→D (AC→T) imalo Karnofsky status ≤ 90 (bilo 80 ili 90).
Currently no data from clinical trials are available on re-treatment of patients with previous exposure to Herzuma in the adjuvant setting. 
Trenutno nema dostupnih podataka dobivenih kliničkim ispitivanjima o ponovnom liječenju bolesnika koji su prethodno adjuvantno liječeni lijekom Herzuma.
If you receive Herzuma with any other medicine to treat cancer, such as paclitaxel, docetaxel, an aromatase inhibitor, capecitabine, 5-fluorouracil, or cisplatin you should also read the patient information leaflets for these products. 
Ako primate lijek Herzuma u kombinaciji s nekim drugim lijekom za liječenje raka, poput paklitaksela, docetaksela, inhibitora aromataze, kapecitabina, 5-fluorouracila ili cisplatina, pročitajte uputu o lijeku i za te lijekove.
Biotec Services International Ltd. Biotec House 
Biotec Services International Ltd.
 If you have any further questions, ask your doctor or pharmacist. 
• Ako imate dodatnih pitanja, obratite se liječniku ili ljekarniku.
In order to prevent medication errors it is important to check the vial labels to ensure that the medicine being prepared and given is Herzuma (trastuzumab) and not trastuzumab emtansine. 
U svrhu sprečavanja medikacijskih pogrešaka, važno je provjeriti naljepnice na bočicama kako biste bili sigurni da je lijek koji se priprema i primjenjuje Herzuma (trastuzumab), a ne trastuzumab emtanzin.
Studies of HER2-positivity rates in gastric cancer (GC) using immunohistochemistry (IHC) and fluorescence in situ hybridisation (FISH) or chromogenic in situ hybridisation (CISH) have shown that there is a broad variation of HER2-positivity ranging from 6.8% to 34.0% for IHC and 7.1% to 42.6% for FISH. 
Ispitivanja stupnja ekspresije HER2 u bolesnika s rakom želuca uporabom imunohistokemije (IHC) i fluorescentne in situ hibridizacije (FISH) ili kromogene in situ hibridizacije (CISH) pokazala su veliku varijabilnost ekspresije HER2 u rasponu od 6,8% do 34,0% kod IHC-a i od 7,1% do 42,6% kod FISH-a.
In patients receiving trastuzumab after completion of adjuvant chemotherapy, the risk of cardiac dysfunction was associated with a higher cumulative dose of anthracycline given prior to initiation of trastuzumab and a body mass index (BMI) > 25 kg/m 
U bolesnika koji su trastuzumab primali nakon završetka adjuvantne kemoterapije, rizik od disfunkcije srca povezivao se s većom kumulativnom dozom antraciklina primijenjenoga prije početka liječenja trastuzumabom te indeksom tjelesne mase (BMI) većim od 25 kg/m
Patients with history of myocardial infarction (MI), angina pectoris requiring medical treatment, history of or existing CHF (NYHA Class II - IV), LVEF of < 55%, other cardiomyopathy, cardiac arrhythmia requiring medical treatment, clinically significant cardiac valvular disease, poorly controlled hypertension (hypertension controlled by standard medical treatment eligible), and hemodynamic effective pericardial effusion were excluded from adjuvant and neoadjuvant EBC pivotal trials with trastuzumab and therefore treatment cannot be recommended in such patients. 
Bolesnici koji su imali infarkt miokarda (IM) u anamnezi, anginu pektoris koju treba liječiti, ranije ili postojeće kongestivno zatajenje srca (NYHA klase II - IV), LVEF < 55%, neku drugu kardiomiopatiju, srčanu aritmiju koju treba liječiti, klinički značajnu bolest srčanih zalistaka, loše kontroliranu hipertenziju (hipertenzija kontrolirana standardnim liječenjem nije predstavljala prepreku) i hemodinamički učinkovit perikardijalni izljev bili su isključeni iz pivotalnih ispitivanja adjuvantnog i neoadjuvantnog liječenja ranog raka dojke trastuzumabom, pa se liječenje za te bolesnike ne može preporučiti.
Table 12 Efficacy results from MO16432 
Tablica 12 Rezultati djelotvornosti iz ispitivanja MO16432
• increased muscle tone or tension (hypertonia) 
• povećani tonus ili napetost mišića
 you have metastatic gastric cancer with high levels of HER2, when it is in combination with the other cancer medicines capecitabine or 5-fluorouracil and cisplatin. 
• bolujete od metastatskog raka želuca s visokom razinom proteina HER2, u kombinaciji s drugim lijekovima za liječenje raka, kapecitabinom ili 5-fluorouracilom i cisplatinom.
If symptomatic cardiac failure develops during Herzuma therapy, it should be treated with standard medicinal products for CHF. 
Ako se tijekom liječenja lijekom Herzuma razvije simptomatsko zatajenje srca, potrebno je primijeniti standardne lijekove koji se propisuju za CHF.
Herzuma intravenous infusion should be administered by a health-care provider prepared to manage anaphylaxis and an emergency kit should be available. 
Intravensku infuziju lijeka Herzuma treba dati stručni zdravstveni radnik obučen za liječenje anafilaksije, a na raspolaganju treba biti oprema za hitne slučajeve.
- following adjuvant chemotherapy with doxorubicin and cyclophosphamide, in combination with paclitaxel or docetaxel. 
- nakon adjuvantne kemoterapije doksorubicinom i ciklofosfamidom u kombinaciji s paklitakselom ili docetakselom
In the neoadjuvant-adjuvant EBC study (BO22227), at a median follow-up exceeding 70 months, 10.1% (30/296) of patients treated with trastuzumab intravenous developed antibodies against trastuzumab. 
U sklopu ispitivanja neoadjuvantnog-adjuvantnog liječenja ranog raka dojke (BO22227), nakon medijana praćenja od više od 70 mjeseci, u 10,1% (30/296) bolesnika liječenih lijekom trastuzumabom za intravensku primjenu razvila su se protutijela na trastuzumab.
which was followed by: - carboplatin - at target AUC = 6 mg/mL/min administered by intravenous infusion over 30 - 60 minutes repeated every 3 weeks for a total of six cycles 
nakon čega je slijedio: - karboplatin - s ciljnom AUC 6 mg/ml/min, primijenjen u intravenskoj infuziji tijekom 30 - 60 minuta, svaka 3 tjedna, ukupno 6 ciklusa.
In the joint analysis of the NSABP B-31 and NCCTG N9831 studies, EBC was limited to women with operable breast cancer at high risk, defined as HER2-positive and axillary lymph node positive or HER2 positive and lymph node negative with high risk features (tumour size > 1 cm and ER negative or tumour size > 2 cm, regardless of hormonal status). 
U skupnoj analizi ispitivanja NSABP B-31 i NCCTG N9831, rani rak dojke je bio ograničen isključivo na žene s operabilnim rakom dojke visokog rizika, definiranim kao HER2 pozitivan s pozitivnim aksilarnim limfnim čvorovima ili HER2 pozitivan s negativnim aksilarnim limfnim čvorovima sa značajkama visokog rizika (veličina tumora > 1 cm i ER negativan ili veličina tumora > 2 cm, bez obzira na hormonski status).
When trastuzumab was administered after completion of adjuvant chemotherapy NYHA Class III - IV heart failure was observed in 0.6% of patients in the one-year arm after a median follow-up of 12 months. 
Kada se trastuzumab primjenjivao nakon završetka adjuvantne kemoterapije, zatajenje srca NYHA klase III-IV primijećeno je u 0,6% bolesnika iz skupine liječene godinu dana nakon medijana od 12 mjeseci praćenja.
Herzuma may be prescribed in combination with the chemotherapy medicine paclitaxel or docetaxel as first treatment for metastatic breast cancer or it may be prescribed alone if other treatments have proved unsuccessful. 
Lijek Herzuma može biti propisan u kombinaciji s kemoterapijskim lijekovima paklitakselom ili docetakselom u prvoj liniji liječenja metastatskog raka dojke ili može biti propisan sam ako su se drugi oblici liječenja pokazali neuspješnima.
In order to prevent medication errors it is important to check the vial labels to ensure that the medicinal product being prepared and administered is Herzuma (trastuzumab) and not Kadcyla (trastuzumab emtansine). 
U svrhu sprečavanja medikacijskih pogrešaka, važno je provjeriti naljepnice na bočicama kako biste bili sigurni da je lijek koji se priprema i primjenjuje Herzuma (trastuzumab), a ne Kadcyla (trastuzumab emtanzin).
In the pivotal trials (H0648g, M77001), paclitaxel or docetaxel was administered the day following the first dose of trastuzumab (for dose, see the Summary of Product Characteristics (SmPC) for paclitaxel or docetaxel) and immediately after the subsequent doses of trastuzumab if the preceding dose of trastuzumab was well tolerated. 
U pivotalnim kliničkim ispitivanjima (H0648g, M77001) paklitaksel ili docetaksel primjenjivan je dan nakon prve doze trastuzumaba (za dozu vidjeti Sažetak opisa svojstava lijeka za paklitaksel ili docetaksel) i neposredno nakon sljedećih doza trastuzumaba ako je bolesnik prethodnu dozu trastuzumaba dobro podnio.
Any remaining reconstituted solution should be discarded. 
Neupotrijebljeni ostatak rekonstituirane otopine potrebno je zbrinuti.
After reconstitution, 1 mL concentrate contains 21 mg of trastuzumab. 
Nakon rekonstitucije, 1 ml koncentrata sadrži 21 mg trastuzumaba.
In the final population PK model, in addition to primary tumour type, body-weight, serum aspartate aminotransferase and albumin were identified as statistically significant covariates affecting the exposure of trastuzumab. 
U konačnom populacijskom farmakokinetičkom modelu, kao statistički značajne kovarijante koje utječu na izloženost trastuzumabu su, uz primarnu vrstu tumora, identificirane i tjelesna težina te razina aspartat aminotransferaze i albumina u serumu.
Always keep this medicine in the closed original pack at a temperature of 2ºC - 8ºC in a refrigerator. 
Sljedeće informacije namijenjene su samo liječnicima i zdravstvenim radnicima Uvijek čuvajte ovaj lijek u zatvorenom originalnom pakiranju u hladnjaku na temperaturi od 2°C - 8°C.
Neutralizing anti-trastuzumab antibodies were detected in post-baseline samples in 2 of 30 patients in the trastuzumab intravenous arm. 
Neutralizirajuća protutijela na trastuzumab pronađena su u uzorcima prikupljenima nakon početka ispitivanja u 2 od 30 bolesnika u skupini liječenoj lijekom trastuzumabom za intravensku primjenu.
From a microbiological point of view, the reconstituted solution and Herzuma infusion solution should be used immediately. 
S mikrobiološkog stajališta, rekonstituiranu otopinu i infuzijsku otopinu lijeka Herzuma potrebno je odmah primijeniti.
Patients with EBC should be treated with Herzuma for 1 year or until disease recurrence, whichever occurs first; extending treatment in EBC beyond one year is not recommended (see section 5.1). 
U bolesnika s ranim rakom dojke liječenje lijekom Herzuma traje godinu dana ili do povrata bolesti, što god nastupi ranije; ne preporučuje se produljiti liječenje ranog raka dojke dulje od jedne godine (vidjeti dio 5.1).
Each vial contains 420 mg trastuzumab that has to be dissolved in 20 mL of water for injection. 
Jedna bočica sadrži 420 mg trastuzumaba koji treba otopiti u 20 ml vode za injekcije.
 Severe dyspnoea at rest due to complications of advanced malignancy or requiring supplementary oxygen therapy. 
• Teška dispneja u mirovanju zbog komplikacija uznapredovale zloćudne bolesti ili potreba za dodatnom terapijom kisikom.
In one of the 3 pivotal studies conducted in which a median follow-up of 5.5 years was available (BCIRG006) a continuous increase in the cumulative rate of symptomatic cardiac or LVEF events was observed in patients who were administered trastuzumab concurrently with a taxane following anthracycline therapy up to 2.37% compared to approximately 1% in the two comparator arms (anthracycline plus cyclophosphamide followed by taxane and taxane, carboplatin and trastuzumab). 
U jednom od 3 provedena pivotalna ispitivanja s medijanom vremena praćenja od 5,5 godina (BCIRG006), u bolesnica koje su nakon anatraciklinske terapije trastzumab primale istodobno s taksanima, zabilježen je kontinuirani porast kumulativne stope simptomatskih srčanih događaja ili događaja povezanih s LVEF-om; do 2,37% u odnosu na oko 1% u dvije usporedne skupine (antraciklin plus ciklofosfamid uz nastavak liječenja taksanima te kombinacija taksana, karboplatina i trastuzumaba).
Congestive heart failure (NYHA Class II - IV) is a common adverse reaction associated with the use of Herzuma and has been associated with a fatal outcome (see section 4.4). 
Kongestivno zatajenje srca (NYHA klase II - IV), česta je nuspojava kod primjene lijeka Herzuma, ponekad povezana i sa smrtnim ishodom (vidjeti dio 4.4).
A final analysis was performed after a median follow-up of 8 years, which showed that 1 year trastuzumab treatment is associated with a 24% risk reduction compared to observation only (HR=0.76, 95% CI 0.67, 0.86). 
Završna analiza provedena nakon medijana praćenja od 8 godina ukazala je na smanjenje rizika od 24% u skupini liječenoj trastuzumabom tijekom 1 godine u usporedbi sa samo opservacijom (HR = 0,76, 95% CI 0,67; 0,86).
Patients who had previously received anthracycline-based adjuvant chemotherapy were treated with paclitaxel (175 mg/m infused over 3 hours) with or without trastuzumab. 
Bolesnice koje su prethodno primale antraciklinsku adjuvantnu kemoterapiju liječene su paklitakselom (175 mg/m u trosatnoj infuziji) u kombinaciji s trastuzumabom ili bez njega.
In rare cases, a reduction in the amount of (amniotic) fluid that surrounds the developing baby within the womb has been observed in pregnant women receiving Herzuma. 
U rijetkim je slučajevima u trudnica koje primaju lijek Herzuma primijećeno smanjenje količine (amnijske) tekućine koja okružuje bebu u razvoju unutar maternice.
Despite the crossover to trastuzumab in the control arm, the addition of trastuzumab to paclitaxel chemotherapy resulted in a 52% decrease in the risk of disease recurrence. 
Unatoč prijelazu na liječenje trastuzumabom u kontrolnoj skupini, dodavanje trastuzumaba kemoterapiji paklitakselom rezultiralo je smanjenjem rizika od ponovne pojave bolesti za 52%.
- cisplatin - 80 mg/m every 3 weeks for 6 cycles on day 1 of each cycle. 
- cisplatin - 80 mg/m svaka 3 tjedna u 6 ciklusa, 1. dan svakog ciklusa.
Table 10 Overview of efficacy analyses BCIRG 006 AC→D versus DCarbH 
Tablica 10 Pregled analize djelotvornosti u ispitivanju BCIRG 006; AC→D u odnosu na DcarbH
Faint ⁄ barely perceptible membranous reactivity in ≥ 10% of tumour cells; cells are reactive only in part of their membrane 
Vrlo slaba/jedva primjetna membranska reaktivnost u ≥ 10% tumorskih stanica; stanice su reaktivne samo u dijelu membrane
In the BCIRG 006 study, trastuzumab was administered either in combination with docetaxel, following AC chemotherapy (AC→DH) or in combination with docetaxel and carboplatin (DCarbH). 
U sklopu ispitivanja BCIRG 006 trastuzumab je primjenjivan u kombinaciji s docetakselom nakon AC kemoterapije (AC→DH) ili u kombinaciji s docetakselom i karboplatinom (DCarbH).
If patients have a continued decrease in left ventricular function, but remain asymptomatic, the physician should consider discontinuing therapy if no clinical benefit of Herzuma therapy has been seen. 
Ako se u bolesnika primijeti kontinuirano smanjenje funkcije lijeve klijetke, koje ostaje asimptomatsko, potrebno je razmotriti prekid terapije lijekom Herzuma ako ona nije polučila nikakvu kliničku korist.
If the patient has missed a dose of Herzuma by more than one week, a re-loading dose of Herzuma should be administered over approximately 90 minutes (weekly regimen: 4 mg/kg; three-weekly regimen: 8 mg/kg) as soon as possible. 
Ako je bolesnik propustio primiti dozu lijeka Herzuma za više od tjedan dana, potrebno je što prije ponoviti udarnu dozu lijeka Herzuma u infuziji trajanja približno 90 minuta (tjedni ciklusi: 4 mg/kg; trotjedni ciklusi: 8 mg/kg).
Infusion-related reactions and hypersensitivity 
Reakcije povezane s infuzijom i preosjetljivost
More patients treated with trastuzumab and paclitaxel progressed in the central nervous system than those treated with paclitaxel alone (12.6% versus 6.5%; p=0.377). 
Pojava metastaza u središnjem živčanom sustavu bila je češća u bolesnica liječenih trastuzumabom i paklitakselom u odnosu na one liječene samo paklitakselom (12,6% naspram 6,5%; p = 0,377).
The frequency of progression in the liver was significantly reduced in patients treated with the combination of trastuzumab and paclitaxel, compared to paclitaxel alone (21.8% versus 45.7%; p=0.004). 
Učestalost pojave metastaza u jetri bila je znatno smanjena u bolesnica liječenih kombinacijom trastuzumaba i paklitaksela u usporedbi sa samim paklitakselom (21,8% naspram 45,7%; p = 0,004).
In the neoadjuvant-adjuvant treatment setting, study MO16432, a multicentre randomised trial, was designed to investigate the clinical efficacy of concurrent administration of trastuzumab with neoadjuvant chemotherapy including both an anthracycline and a taxane, followed by adjuvant trastuzumab, up to total treatment duration of 1 year. 
U sklopu neoadjuvantnog-adjuvantnog liječenja, multicentrično, randomizirano ispitivanje MO16432 osmišljeno je da ispita kliničku djelotvornost istodobne primjene trastuzumaba s neoadjuvantnom kemoterapijom, koja je uključivala i antraciklin i taksan, nakon čega je slijedilo adjuvantno liječenje trastuzumabom do ukupno 1 godine liječenja.
Herzuma in combination with capecitabine or 5-fluorouracil and cisplatin is indicated for the treatment of adult patients with HER2 positive metastatic adenocarcinoma of the stomach or gastro-esophageal junction who have not received prior anti-cancer treatment for their metastatic disease. 
Lijek Herzuma je u kombinaciji s kapecitabinom ili 5-fluorouracilom i cisplatinom indiciran u liječenju odraslih bolesnika s HER2 pozitivnim metastatskim adenokarcinomom želuca ili gastroezofagealnog spoja, koji nisu prethodno primali kemoterapiju za metastatsku bolest.
- capecitabine - 1000 mg/m orally twice daily for 14 days every 3 weeks for 6 cycles (evening of day 1 to morning of day 15 of each cycle) 
- kapecitabin - 1000 mg/m² peroralno, dvaput dnevno, tijekom 14 dana svaka 3 tjedna u 6 ciklusa (od večeri 1. dana do jutra 15. dana svakog ciklusa)
In the pivotal trial BO22227, trastuzumab was administered concurrently with neoadjuvant chemotherapy that contained four cycles of epirubicin (cumulative dose 300 mg/m2); at a median follow-up exceeding 70 months, the incidence of cardiac failure/congestive cardiac failure was 0.3% in the trastuzumab intravenous arm. 
U pivotalnom ispitivanju BO22227, trastuzumab se primjenjivao istodobno s neoadjuvantnom kemoterapijom koja se sastojala od četiri ciklusa epirubicina (kumulativna doza: 300 mg/m2); nakon medijana praćenja od više od 70 mjeseci, incidencija zatajenja srca/kongestivnog zatajenja srca iznosila je 0,3% u skupini koja je primala trastuzumab intravensku primjenu.