Drug Action
Pertuzumab is a recombinant humanised monoclonal antibody, and acts by inhibiting human epidermal growth factor receptor 2 protein (HER2) dimerisation.
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Drug reference
Pertuzumab is a recombinant humanised monoclonal antibody, and acts by inhibiting human epidermal growth factor receptor 2 protein (HER2) dimerisation.
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HER2-positive early stage breast cancer (in combination with trastuzumab and chemotherapy)| HER2-positive metastatic or locally recurrent unresectable breast cancer (in combination with trastuzumab and docetaxel) (specialist use only) ▶BY INTRAVENOUS INFUSION ▶Adult: (consult product literature or local protocols)
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Conditions that could impair left ventricular function. history of congestive heart failure. impaired left ventricular function. prior anthracycline exposure. radiotherapy to the chest area. recent myocardial infarction. serious cardiac arrhythmia. uncontrolled hypertension
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NICE decisions ▶Pertuzumab for the neoadjuvant treatment of HER2-positive breast cancer (December 2016) NICE TA424 Pertuzumab (Perjeta ®), in combination with trastuzumab and chemotherapy, is recommended, within its marketing authorisation, as an option for neoadjuvant treatment in adults with human epidermal growth factor receptor 2 (HER2-positive), locally advanced, inflammatory or early- stage breast cancer at high risk of recurrence, only if the manufacturer provides it with the discount agreed in the patient access scheme. www.nice.org.uk/guidance/ta424 ▶Pertuzumab with trastuzumab and docetaxel for treating HER2-positive breast cancer (March 2018) NICE TA509 Pertuzumab (Perjeta ®), in combination with trastuzumab and docetaxel, is recommended, within its marketing authorisation, for treating HER2-positive metastatic or locally recurrent unresectable breast cancer, in adults who have not had previous anti-HER2 therapy or chemotherapy for their metastatic disease, only if the manufacturer provides pertuzumab within the agreed commercial access arrangement. www.nice.org.uk/guidance/ta509 ▶Pertuzumab for adjuvant treatment of HER2-positive early stage breast cancer (March 2019) NICE TA569 Pertuzumab (Perjeta ®), with intravenous trastuzumab and chemotherapy, is recommended for the adjuvant treatment of human epidermal growth factor receptor 2 (HER2)-positive early stage breast cancer in adults, only if they have lymph node-positive disease and the manufacturer provides it according to the commercial arrangement. Patients whose treatment was started within the NHS before this guidance was published should have the option to continue treatment, without change to their funding arrangements, until they and their NHS clinician consider it appropriate to stop. www.nice.org.uk/guidance/ta569 Scottish Medicines Consortium (SMC) decisions SMC No. SMC2119 The Scottish Medicines Consortium has advised (December 2018) that pertuzumab (Perjeta ®) is accepted for use within NHS Scotland in combination with trastuzumab and chemotherapy for the neoadjuvant treatment of adults with HER2-positive, locally advanced, inflammatory, or early stage breast cancer at high risk of recurrence. This advice is contingent upon the continuing availability of the patient access scheme in NHS Scotland or a list price that is equivalent or lower. SMC No. SMC2120 The Scottish Medicines Consortium has advised (January 2019) that pertuzumab (Perjeta ®) is accepted for use within NHS Scotland in combination with trastuzumab and docetaxel, in adults with HER2-positive metastatic or locally recurrent unresectable breast cancer, who have not received previous anti-HER2 therapy or chemotherapy for their metastatic disease. This advice is contingent upon the continuing availability of the patient access scheme in NHS Scotland or a list price that is equivalent or lower. SMC No. SMC2197 The Scottish Medicines Consortium has advised (October 2019) that pertuzumab (Perjeta ®) is not recommended for use within NHS Scotland in combination with trastuzumab and chemotherapy for the adjuvant treatment of adults with HER2-positive early breast cancer at high risk of recurrence as the clinical and economic case was not demonstrated.
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→Appendix 1: monoclonal antibodies
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▶Common or very common Alopecia. anaemia. appetite decreased. arthralgia. asthenia. chills. congestive heart failure. constipation. cough. cytokine release syndrome. diarrhoea. dizziness. dyspepsia. dyspnoea. excessive tearing. fever. headache. hypersensitivity. increased risk of infection. infusion related reaction. insomnia. left ventricular dysfunction. leucopenia. mucositis. myalgia. nail disorder. nausea. neutropenia. oedema. pain. peripheral neuropathy. respiratory disorders. skin reactions. stomatitis. taste altered. vomiting SIDE-EFFECTS, FURTHER INFORMATION Side effects mostly described for pertuzumab in combination with trastuzumab and docetaxel.
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Ensure effective contraception during and for six months after treatment in women of childbearing potential.
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Avoid (toxicity in animal studies). Most cytotoxic drugs are teratogenic and should not be administered during pregnancy, especially during the first trimester. Considerable caution is necessary if a pregnant woman presents with cancer requiring chemotherapy, and specialist advice should always be sought.
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Avoid—no information available.
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Manufacturer advises caution (no information available).
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Caution in severe impairment—no information available.
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▶Assess for signs and symptoms of congestive heart failure (including left ventricular ejection fraction) before and during treatment—consult product literature, and withhold treatment if necessary. ▶Monitor for febrile neutropenia.
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Resuscitation facilities should be available.
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There can be variation in the licensing of different medicines containing the same drug. Solution for infusion ▶Perjeta (Roche Products Ltd) Pertuzumab 30 mg per 1 ml Perjeta 420mg/14ml concentrate for solution for infusion vials | 1 vial P £2,395.00 (Hospital only)
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(consult product literature or local protocols)
First-line fragment. Read the complete Indications and Dose section above.
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