Drug updated on 4/15/2024
| Dosage Form | Injection (intravenous; 420 mg/14 mL) |
| Drug Class | HER2/neu receptor antagonists |
| Ongoing and Completed Studies | ClinicalTrials.gov |
Indication
- Indicated for use in combination with trastuzumab and docetaxel for treatment of patients with HER2-positive metastatic breast cancer (MBC) who have not received prior anti-HER2 therapy or chemotherapy for metastatic disease.
- Indicated for use in combination with trastuzumab and chemotherapy as neoadjuvant treatment of patients with HER2-positive, locally advanced, inflammatory, or early stage breast cancer (either greater than 2 cm in diameter or node positive) as part of a complete treatment regimen for early breast cancer.
- Indicated for use in combination with trastuzumab and chemotherapy as adjuvant treatment of patients with HER2-positive early breast cancer at high risk of recurrence.
Summary
- Pertuzumab (Perjeta) is indicated for use in combination with trastuzumab and docetaxel for the treatment of patients with HER2-positive metastatic breast cancer who have not received prior anti-HER2 therapy or chemotherapy, as well as for the neoadjuvant and adjuvant treatment of patients with HER2-positive early-stage breast cancer.
- The information provided comes from a review of 27 systematic reviews/meta-analyses related to Pertuzumab (Perjeta).
- When used in combination therapies, Pertuzumab demonstrates an optimal balance of efficacy and safety in treating HER2-positive metastatic breast cancer. It shows superior progression-free survival, overall survival, and a higher pathological complete response rate compared to therapies without Pertuzumab.
- Compared to single-targeted therapies, dual HER2-targeted therapies involving Pertuzumab show significant improvements in terms of progression-free survival, overall survival rates, and objective response rates. This benefit has been underlined across different stages of breast cancer care by trials like CLEOPATRA, APHINITY, NeoSphere, and TRYPHAENA.
- Adverse effects associated with Pertuzumab include diarrhea, rash, mucosal inflammation, and epistaxis, which are generally tolerable. Common adverse effects associated with other treatments such as trastuzumab, lapatinib, TDM1 present variable profiles. Pertuzumab, in particular, when combined with trastuzumab, presents manageable toxicity levels.
- The benefits might be more pronounced among certain subgroups, including those having hormone receptor-negative status or node-positive disease, indicating the importance of patient selection while optimizing strategies. There's also an indication that it may offer limited benefit to patients having node-negative small primary tumors, suggesting the need for further research to identify patient subgroups that would gain the most from these therapies.
- Cost-effectiveness could be a consideration, especially in determining its broader clinical practice. The high efficacy in extending progression-free and overall survival needs to be balanced with economic considerations when adding Pertuzumab to the treatment regimen.
- Future research is advocated to fine-tune the optimal combinations, durations, and sequences of Pertuzumab-containing regimens. The exploration of Pertuzumab's role in de-escalated therapies for low-risk groups or in the adjuvant setting post-complete response is an ongoing area of study.
Product Monograph / Prescribing Information
| Document Title | Year | Source |
|---|---|---|
| Perjeta (pertuzumab) Prescribing Information. | 2021 | Genentech Inc., South San Francisco, CA |