Pertuzumab (Intravenous)

Pertuzumab is an injected medication prescribed by doctors in the early treatment for breast cancer for women who have been diagnosed with the HER2 positive type.

Overview

What is Pertuzumab?

Pertuzumab is used in the treatment of breast cancer along with two other drugs, docetaxel and trastuzumab. It is sold under the trade name of Perjeta in the US.

The patients who receive this type of treatment have tested positive for the HER2 protein, which is a substance that some breast tumors produce when they are active in the body. Through its cellular structure, designed to be similar to the HER2 protein, it bonds with the receptor cells in the cancer protein and stops them from interacting with other proteins.

How does Pertuzumab work?

Pertuzumab enters the body as a protein with a very similar structure to the HER2 protein that is produced by breast cancer tumors. In a breast cancer patient, these proteins have been over stimulated and are causing growth patterns that are uncontrollable. The HER2 protein begins to bond with other HER family receptors and take over the healthy tissue.

By mimicking the same protein receptors found in the HER family and bonding with HER2 in its place, Pertuzumab prevent further bonding and effectively stop the growth of the cancer. Other drugs then step in to provide chemotherapy and recovery for the patient.

Conditions Treated

  • Locally advanced breast cancer
  • Inflammatory carcinoma of the breast
  • Stage I breast carcinoma
  • Metastatic breast cancer

Type Of Medicine

Humanized monoclonal antibody

Side Effects

Patients who have been prescribed treatment with Pertuzumab may experience some adverse health effects that can severely harm them. If you have the following symptoms, seek medical assistance immediately:

  • Pain, tingling, numbness or burning
  • Stool is black or tar-like
  • Coughing
  • Chills
  • Rapid heart rhythm
  • Fever
  • Rashes, itching or hives
  • Hoarse voice
  • Stiff, swollen, painful joints
  • Pain in side or lower back
  • Urination is difficult or painful
  • Skin is pale
  • Skin redness
  • Throat is sore
  • Swollen hands, feet, face, eyes or lips
  • Chest tightness
  • Trouble swallowing or breathing
  • Ulcerated white spots in mouth
  • Awkward, unsteady movement
  • Bruising or bleeding that is unusual or unexpected
  • Fatigue
  • Muscle weakness
  • Weak hands, feet, legs or arms

Other health effects may occur that, while not severe or harmful in nature, may cause you stress or discomfort. These side effects should disappear as your treatment goes on, but if they do not or if they become severe, discuss these with your doctor:

  • Pain in the body or achy muscles
  • Taste changes or is gone
  • Lips become dry and cracked
  • Appetite decreases
  • Dizzy
  • Diarrhea
  • Skin is dry
  • Ears become congested
  • Hair thins or falls out
  • Headache
  • Fingernails become loose
  • Voice lost
  • Nasal stuffiness, sneezing, congestion, runniness
  • Nausea
  • Fingernails are sore or red
  • Eyes water
  • Vomiting

You may have your own experiences on this medication that are different from those listed here. If you have any changes in your health while you are taking Pertuzumab, it is best to notify your cancer treatment staff immediately to make sure you are safe to continue your treatment on this drug.

Dosage

This medication is commonly used in the early stages of breast cancer to fight the disease in combination with other drugs. Your dosage will be determined especially for you by your cancer treatment care team. The amount and frequency you are given this drug is based on several factors which include your overall health, the state of your cancer, any previous treatment you may have and your body mass statistics. The information provided here is general; what your treatment is with Pertuzumab may vary.

Pertuzumab, along with docetaxel and trastuzumab, are often given to patients with the goal of shrinking their breast cancer tumors. This is called a neoadjuvant dosage.

In general, the initial dose of Pertuzumab for neoadjuvant treatment is 840 milligrams via intravenous infusion over a one hour period. The next dosage is 420 milligrams that is given in a thirty to sixty minute period for the next three weeks in cycles ranging from three to six times. The other drugs will also be given during your treatment cycle in different doses and different sequences.

Patients who have breast cancer that has spread to a secondary site within the body, known as metastatic breast cancer, may receive the same combination therapy, dosage and cycle as other patients. Treatment of this type of cancer is up to the cancer treatment therapy team of physicians and nurses.

Interactions

If you have had any unusually hypersensitive reactions to other medications in the past or if you have reacted poorly to some animals, foods, preservatives or dyes, inform your doctor of this possibility. You could also have this sensitivity to Pertuzumab.

Pediatric patients have not been studied to determine if they are safe to be treated with Pertuzumab.

Studies on geriatric patients have been performed and no difference in risk or effectiveness has been found with regard to use of Pertuzumab in this age group.

Pregnant women under treatment with Pertuzumab with trastuzumab may be exposing their fetus to harm by taking these drugs. It is important to prevent pregnancy while under treatment of these drugs and reliable forms of birth control should be used. Discuss your treatment options with your team of cancer care specialists and inform your doctor if you are pregnant prior to your treatment.

Pertuzumab has not been studied for use in women who are breastfeeding to determine if their bodies transport this drug within the breast milk. Discuss any risks that may exist with the use of this medication with your doctor if you are currently breastfeeding.

Certain medications should not be used together; in the case of Pertuzumab, it is safe to use with two other drugs as part of a complete therapy against breast cancer. Do not take other drugs while you are being treated with Pertuzumab; this includes anything you can get over-the-counter, any herbal, holistic or vitamin therapies that are available.

The following drugs should not be combined with Pertuzumab unless your physician has specifically approved their use:

  • Ancestim
  • Acetyldigitoxin
  • Belimumab
  • Acetyldigoxin
  • Cabazitaxel
  • BCG vaccine
  • Bevacizumab
  • Clostridium tetani toxoid antigen (formaldehyde inactivated)
  • Cymarin
  • Corynebacterium diphtheriae toxoid antigen (formaldehyde inactivated)
  • Cyclophosphamide
  • Digoxin
  • Deslanoside
  • Digitoxin
  • Digoxin Immune Fab (Ovine)
  • GI-5005
  • Docetaxel
  • G17DT
  • Hepatitis B Vaccine (Recombinant)
  • Gitoformate
  • Hepatitis A Vaccine
  • INGN 225
  • Metildigoxin
  • INGN 201
  • Lanatoside C
  • Ouabain
  • Oleandrin
  • Peruvoside
  • Paclitaxel
  • Rabies virus inactivated antigen, A
  • Proscillaridin
  • Rotavirus Vaccine
  • Rindopepimut
  • Salmonella typhi ty21a live antigen
  • Rubella virus vaccine
  • Tecemotide
  • SRP 299
  • Trastuzumab
  • TG4010
  • Yellow fever vaccine
  • Varicella Zoster Vaccine (Live/Attenuated)

Patients who have been diagnosed with cardiac problems such as congestive heart failure should not be given treatment with Pertuzumab, as the risk of making this condition more acute exist with the use of this drug.

Warnings

As a cancer patient, you will be scheduled for regular monitoring of your progress with regard to the effectiveness of this drug on your condition. You will also be reviewed for any ill effects you may be suffering due to the use of Pertuzumab. Maintain your appointment schedule and follow the advice given to you by your team of cancer treatment specialists.

Fetal harm has been known to occur with use of Pertuzumab on women who are pregnant. If you are at risk for becoming pregnant while being treated with this drug, it is strongly recommended that you use reliable forms of birth control at this time and for at least seven months after your treatment schedule is complete. If you think you may be pregnant, alert your doctor immediately.

Pertuzumab has been known to increase the risk for heart failure in some patients. As a precautionary step, your physician will most likely test your heart function prior to your treatment with this medication, repeating the test at intervals over the course of your treatment regime. If you experience chest pain, have difficulty breathing, begin to gain weight rapidly or have swollen legs or ankles, these are symptoms that should be reported to your physician right away as they could be signs of a serious health problem.

Patients who have chills, fever, fainting, dizziness, lightheadedness, chest pain, headache, skin rash, body aches, vomiting, nausea, difficulty breathing or weak muscles shortly after their intravenous dose of Pertuzumab may be at risk of a reaction to the infusion process that could be life threatening. Seek immediate medical assistance if you have any of these symptoms.

A heightened risk of hypersensitive reactions to this medication exists in some patients. Report any signs of difficulty swallowing or breathing, skin itching or rashes, swollen lips, face or hands to your medical team as soon as possible.

It is common for cancer treatment medications such as Pertuzumab to cause nausea and even vomiting even if you have been given anti-nausea medication to stop this from happening. If you still get nauseated after treatment, seek the advice of your cancer treatment team.

Storage

This medication is used only by licensed medical professionals in the appropriate setting, which is a hospital or cancer treatment center or clinic. Use and storage safety are under the advice of the manufacturer and carried out by the treatment team.

Pertuzumab should be refrigerated but protected from freezing and never shaken. The vial should remain in the original carton, which will protect it from light. Once diluted, use Pertuzumab within twenty four hours or discard safely according to manufacturer's instructions.

Summary

Pertuzumab is a cancer drug that is considered to be targeted therapy and the result of many years of research to understand how cancer cells work and grow. Rather than killing cancer cells, Pertuzumab mimics the proteins they use to grow and divide, providing them another substance to bond with and stopping their growth. Once stopped, the cancer cells can be killed before spreading to other parts of the body by the drugs that will be used in combination with Pertuzumab.

Unfortunately, due to this very strong mimic of normal protein cells, Pertuzumab may cause unwanted health effects to normal cells. Commonly, Pertuzumab makes patients nauseated and causes vomiting. Patients may also lose their ability to speak or have symptoms as if they had a cold. Their skin may go dry and they may feel dizzy or achy. Their nose could run and their eyes could water. Any symptoms that continue for a prolonged period of time after treatment or those that are considered severe should be reported to your cancer treatment professionals right away.

Pertuzumab poses a risk of cardiac symptoms and should not be used on patients who have been diagnosed with congestive heart failure. Patients will be tested regularly during treatment to make sure their heart remains healthy over the course of treatment.

Resources
Last Reviewed:
March 26, 2018
Last Updated:
April 05, 2018
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