Pertuzumab

Pertuzumab is a prescription medication used for the treatment of Early Breast Cancer and Metastatic Breast Cancer. 

• Pertuzumab is available under the following different brand names: Perjeta

Adult dosage

Injectable Solution

• 30mg/mL (420mg/14 mL)

Early Breast Cancer

Adult dosage

• Neoadjuvant treatment
  • Initial dose: Pertuzumab 840 mg IV(intravenous) infusion, then 420 mg IV infusion every 3Weeks AND
  • Trastuzumab: 8 mg/kg IV infusion initially, then 6 mg/kg IV infusion q3Weeks OR
  • Trastuzumab hyaluronidase-ok: 600 mg/10,000 units (600 mg trastuzumab and 10,000 units hyaluronidase) SC(subcutaneous) every3Weeks irrespective of body weight
  • Docetaxel: 75 mg/m² IV infusion initially; may increase to 100 mg/m² IV(intravenous) infusion every 3Weeks if the initial dose is well tolerated
• Adjuvant treatment
  • Initial dose: Pertuzumab 840 mg IV infusion, then 420 mg IV infusion every3Weeks AND
  • Trastuzumab: 8 mg/kg IV initially, then 6 mg/kg IV every3Weeks OR
  • Trastuzumab hyaluronidase-ok: 600 mg/10,000 units (600 mg trastuzumab and 10,000 units hyaluronidase) SC every 3Weeks irrespective of body weight

Metastatic Breast Cancer

Adult dosage

• Initial dose: 840 mg IV infusion over 60 min, then 420 mg IV infusion over 30-60 min every 3 weeks thereafter
• Trastuzumab: 8 mg/kg IV infusion over 90 min initially, THEN 6 mg/kg IV infusion over 30-90 mins every 3 weeks thereafter
• Docetaxel: 75 mg/m² IV infusion initially; may increase to 100 mg/m² IV infusion every 3 weeks if the initial dose is well tolerated

Dosage Considerations – Should be Given as Follows: 

• See “Dosages”

Common side effects of Pertuzumab include:

• heart problems,
• diarrhea,
• nausea,
• vomiting,
• tiredness,
• loss of appetite,
• dry skin,
• rash or itching,
• numbness or tingling in the hands or feet, or
• cold symptoms such as stuffy nose, sneezing, or sore throat

Serious side effects of Pertuzumab include:

• hives,
• difficulty breathing,
• swelling of the face, lips, tongue, or throat,
• weakness,
• tiredness,
• nausea,
• fast or slow heartbeat,
• headache,
• fever,
• chills,
• muscle pain,
• unusual taste in the mouth,
• dizziness,
• pounding heartbeats,
• fluttering in your chest,
• new or worsening cough,
• shortness of breath,
• swelling in the lower legs,
• mouth sores,
• skin sores,
• easy bruising,
• unusual bleeding,
• pale skin,
• cold hands and feet,
• lightheadedness,
• confusion,
• muscle cramps,
• vomiting,
• decreased urination, and
• tingling in the hands and feet or around the mouth

Rare side effects of Pertuzumab include:

• none 

This is not a complete list of side effects and other serious side effects or health problems that may occur as a result of the use of this drug. Call your doctor for medical advice about serious side effects or adverse reactions. You may report side effects or health problems to FDA at 1-800-FDA-1088.

If your medical doctor is using this medicine to treat your pain, your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor, health care provider, or pharmacist first.

• Pertuzumab has no noted severe interactions with any other drugs
• Pertuzumab has no noted serious interactions with any other drugs
• Pertuzumab has no noted moderate interactions with any other drugs
• Pertuzumab has no noted  minor interactions with any other drugs

This information does not contain all possible interactions or adverse effects. Visit the RxList Drug Interaction Checker for any drug interactions. Therefore, before using this product, tell your doctor or pharmacist about all your products. Keep a list of all your medications with you and share this information with your doctor and pharmacist. Check with your health care professional or doctor for additional medical advice, or if you have health questions or concerns.

Contraindications

• Hypersensitivity

Effects of drug abuse

• None

Short-Term Effects

• See “What Are Side Effects Associated with Using Pertuzumab?”

Long-Term Effects

• See “What Are Side Effects Associated with Using Pertuzumab?”

Cautions

• Decreases in LVEF have been reported with drugs that block HER2 activity; assess LVEF before initiation of pertuzumab and monitor regularly during treatment (see Dosage Modifications and Black Box Warnings)
• Fetal harm may occur when pertuzumab is administered to a pregnant woman (see Pregnancy)
• Infusion reactions have been associated with pertuzumab administration; observe patients closely for 60 minutes after the first infusion and 30 minutes after subsequent pertuzumab infusions (see Dosing Modifications)
• Severe hypersensitivity, including anaphylaxis, has been observed in clinical trials; monitor and treat appropriately if such reactions occur (see Contraindications and Dosage Modifications)
• Cases of possible tumor lysis syndrome reported; patients with significant tumor burden (e.g., bulky metastases) may be at higher risk; patients could present with hyperuricemia, hyperphosphatemia, and acute renal failure which may represent possible TLS; providers should consider additional monitoring and/or treatment as clinically indicated

Pregnancy & Lactation

• There is a pregnancy pharmacovigilance program for therapy administered during pregnancy, or if the patient becomes pregnant while receiving therapy or within 7 months following the last dose in combination with trastuzumab, health care providers and patients should immediately report exposure to Genentech at 1-888-835-2555
• Based on its mechanism of action and findings in animal studies, therapy can cause fetal harm when administered to a pregnant woman; there is no available data on the use of the drug in pregnant women; however, in post-marketing reports, the use of another HER2/neu receptor antagonist (trastuzumab) during pregnancy resulted in cases of oligohydramnios and oligohydramnios sequence manifesting as pulmonary hypoplasia, skeletal abnormalities, and neonatal death
• Monitor women who received the drug in combination with trastuzumab during pregnancy or within 7 months before conception for oligohydramnios; if oligohydramnios occurs, perform fetal testing that is appropriate for gestational age and consistent with community standards of care
• Verify pregnancy status of females of reproductive potential before initiation of therapy
• Based on the mechanism of action and animal data, the drug can cause embryo-fetal harm when administered during pregnancy; advise females of reproductive potential to use effective contraception during treatment and for 7 months following the last dose in combination with trastuzumab
• Lactation
  • There is no information regarding the presence of the drug in human milk, effects on the breastfed infant, or milk production; published data suggest that human IgG is present in human milk but does not enter neonatal and infant circulation in substantial amounts; consider developmental and health benefits of breastfeeding along with mother’s clinical need for treatment and any potential adverse effects on the breastfed child or from the underlying maternal condition; consideration should also take into account elimination half-life of pertuzumab and a trastuzumab washout period of 7 months