Pertuzumabinfo-icon (Perjeta) is a targeted therapyinfo-icon used to treat early-stageinfo-icon and metastatic HER2-positive breast cancer. Pertuzumab is a monoclonal antibodyinfo-icon, a type of medicineinfo-icon made in a lab that targets a specific proteininfo-icon, HER2, produced on the outside of a cellinfo-icon. It falls in a class of medicines called targeted therapies.

In 2013, the FDAinfo-icon approved pertuzumab for use in early-stage disease when given at the same time as the targeted therapy trastuzumab (Herceptin and biosimilars) and the chemotherapyinfo-icon medicine docetaxel (Taxotere). It was the first breast cancer medicine to be approved by the FDA specifically as neoadjuvant therapyinfo-icon. It was approved in 2017 to be given with trastuzumabinfo-icon for adjuvant treatment as well and for people who have a high risk of recurrenceinfo-icon.

How pertuzumab works

Pertuzumabinfo-icon works by blocking signals that tell breast cancer cells to multiply. After attaching to cancer cells, it can also alert the immune systeminfo-icon to kill them.

Who gets pertuzumab

Pertuzumabinfo-icon may be given with trastuzumabinfo-icon after surgeryinfo-icon to people with early-stageinfo-icon, HER2-positive breast cancer that is at high risk of returning or spreading away from the breast.

You may be able to take pertuzumab as neoadjuvant treatment, treatment given before breast surgery, for early-stage HER2-positive breast cancer if the cancer is

  • larger than 2 centimeters across, or
  • locally advanced, meaning it has traveled to nearby tissueinfo-icon or lymphinfo-icon nodes, or
  • inflammatory, a type of breast cancer in the skin of the breast that causes the breast to look red and swollen and feel warm to the touch

After getting neoadjuvant treatment and surgery, you may continue taking pertuzumab and trastuzumab to complete up to 1 year of treatment.

In metastaticinfo-icon breast cancer, pertuzumab is used for HER2-positive breast cancer that has not yet been treated with trastuzumab or with chemotherapyinfo-icon after a stage IV diagnosisinfo-icon. A 2014 ASCO guideline recommends the combination of trastuzumab and pertuzumab, two medicines that attack HER2 proteins, along with taxaneinfo-icon-based chemotherapy, as a first treatment for metastatic breast cancer.

You and your doctor will discuss the best treatment plan for your situation.

How pertuzumab is given

Pertuzumabinfo-icon given by veininfo-icon uses a needle or a port to drip medicineinfo-icon directly into a vein in a process called an infusioninfo-icon. The doseinfo-icon is based on how much you weigh. Infusions last between 30 minutes and an hour, after a first infusion that lasts an hour or longer. Infusions are given once every 3 weeks.

The treatment can also be given as pertuzumab, trastuzumabinfo-icon, and hyaluronidase-zzxf (Phesgo), a combination of trastuzumab and pertuzumab delivered together by inserting a needle under the skin, usually in the thigh, once every 3 weeks. The injectioninfo-icon takes about 5 minutes and the dose is fixed, meaning it doesn’t change based on your weight.

In early-stageinfo-icon disease, you may receive pertuzumab for up to 18 weeks before surgeryinfo-icon and continue to take it alongside trastuzumab or in pertuzumab, trastuzumab, and hyaluronidase-zzxf to complete a year of treatment. If recommended only after surgery, pertuzumab and trastuzumab or pertuzumab, trastuzumab, and hyaluronidase-zzxf may be taken for up to a year.

Side effects and things to remember

When pertuzumabinfo-icon is given with trastuzumabinfo-icon and chemotherapyinfo-icon, the side effects people experience most often are:

If you are getting chemotherapy and trastuzumab along with pertuzumab, you also may have side effects of trastuzumab and chemotherapy.

Trastuzumab is known to cause heart problems, but studies show that adding pertuzumab to trastuzumab doesn’t raise the risk. It’s unlikely you’ll have serious heart problems while taking these medicines, but it’s important your doctor monitor your heart health during treatment.

Before starting pertuzumab tell your doctor about any medicines you are taking, including vitamins, herbal supplements and over-the-counterinfo-icon medicines. Pertuzumab may be dangerous to a fetus if taken while pregnant. You should not take it if you are pregnant or breastfeeding, and you should take steps to avoid getting pregnant while on pertuzumab.

Your doctor, pharmacistinfo-icon or nurseinfo-icon can help you manage your side effects. You can also go to our section on side effects for more information.

March 25, 2021