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Pertuzumab

(per-too-zuh-mab)

Trade/other name(s): Perjeta

Why would this drug be used?

This drug is used to treat certain types of breast cancer, and is being studied for other conditions as well.

How does this drug work?

Pertuzumab is a type of targeted immunotherapy known as a monoclonal antibody. A monoclonal antibody is a man-made version of an immune system protein that fits like a lock and key with a certain protein.

Pertuzumab is designed to seek out and lock onto a protein called human epidermal growth factor receptor 2 (HER2), which is found on certain cells in the body. About 1 out of 5 breast cancers have higher than normal numbers of HER2 on the surface of the cancer cells, which helps these cells grow. By attaching to these HER2 proteins, pertuzumab blocks the growth signals they send. Pertuzumab also attracts immune cells to help kill the cancer cells.

Your doctor will have a sample of your cancer cells tested before treatment. If the sample does not show the cancer cells have too much of the HER2 protein, this drug will not be used because it is very unlikely to be helpful.

Before taking this medicine

Tell your doctor…

  • If you are allergic to anything, including medicines, dyes, additives, foods.
  • If you have any medical conditions such as kidney disease, liver disease (including hepatitis), heart disease, diabetes, gout, or infections. These conditions may affect which medicines you can get.
  • If you have ever had congestive heart failure, radiation to the chest, or if you have ever had medicines that may have damaged your heart. This drug may raise your risk of heart failure (see the “Precautions” section).
  • If you are pregnant, trying to get pregnant, or if there is any chance of pregnancy. This drug could harm the fetus if it is given to a woman during pregnancy. (It is not known if it might cause problems if the male is taking it at the time of conception.) Check with your doctor about what kinds of birth control can be used with this medicine (see the “Precautions” section). Tell your doctor right away if you become pregnant or think you may be pregnant.
  • If you are breastfeeding. While no studies have been done, this drug may pass into breast milk and affect the baby. Women should avoid breastfeeding during treatment and for several months after receiving the last dose of this drug.
  • If you think you might want to have children in the future. It is not known if this drug can affect fertility. Talk with your doctor about the possible risk with this drug and the options that may preserve your ability to have children.
  • About any other prescription or over-the-counter medicines you are taking, including vitamins and herbs. In fact, keeping a written list of each of these medicines (including the doses of each and when you take them) with you in case of emergency may help prevent complications if you get sick.

Interactions with other drugs

It is not yet clear if pertuzumab can damage the heart (see “Precautions”), but similar drugs have been found to affect the heart. Pertuzumab could possibly interact with other drugs known to damage the heart, such as certain chemotherapy drugs called anthracyclines. Examples include doxorubicin (Adriamycin), daunorubicin (Cerubidine, Daunomycin), epirubicin (Ellence), and mitoxantrone (Novantrone).

No other serious interactions are known at this time, but this does not necessarily mean that none exist. Check with your doctor, nurse, or pharmacist about all other medicines, herbs, and supplements you take, and whether alcoholic beverages can cause problems with this medicine.

Interactions with foods

No serious interactions with food are known at this time. Check with your doctor, nurse, or pharmacist about whether some foods may be a problem.

Tell all the doctors, dentists, nurses, and pharmacists you visit that you are taking this drug.

How is this drug taken or given?

Pertuzumab is given by infusion in a vein. The first dose is given over about an hour. You will be watched closely during the infusion and for about an hour afterward to see if you have any type of allergic reaction to the drug (see “Precautions”). If you don't have any problems, the next time you get the drug it may be given over 30 to 60 minutes.

This medicine is given along with other cancer drugs, once every 3 weeks. If you have problems such as a change in heart function, the next dose may need to be delayed or the drug may need to be stopped altogether.

Precautions

This drug can cause allergic reactions in some people when the drug is given, especially with the first treatment. Mild reactions usually consist of fever and chills. More serious reactions happen rarely, but can be dangerous. Symptoms can include feeling lightheaded or dizzy (due to low blood pressure), fever or chills, hives, nausea, itching, headache, coughing, tightness in the throat, shortness of breath, or swelling of the face, tongue, or eyes. Your doctor or nurse will watch you closely while you are getting the drug and for about an hour afterward, especially the first time you get it. Tell your doctor or nurse right away if you notice any of these symptoms during or after being given the drug.

Women should avoid getting pregnant during and for at least 6 months after treatment with this drug in order to prevent harm to the fetus. Your doctor should check to make sure you’re not pregnant before starting treatment. Talk with your doctor about what kind of birth control you can use with this medicine. Tell your doctor right away if you become pregnant or think you may be pregnant.

This drug may cause damage to the heart. Your doctor will probably test your heart function before treatment and every few months while you are getting this drug. Possible symptoms of heart damage might include chest pain, increased coughing, trouble breathing (especially at night), rapid weight gain (5 pounds or more in 24 hours), dizziness, fainting, or swelling in the ankles or legs. Tell your doctor right away if you start to notice any of these symptoms once treatment starts.

Your doctor will probably test your blood throughout your treatment, looking for possible effects of the drug on blood counts (described below) or on other body organs. Based on the test results, you may be given medicines to help treat any effects. Your doctor may also need to delay your next dose of this drug, or even stop it altogether. Keep all your appointments for lab tests and doctor visits.

This drug can lower your white blood cell count, which can increase your chance of getting an infection. Be sure to let your doctor or nurse know right away if you have any signs of infection, such as fever (100.5° or higher), chills, pain when passing urine, new onset of cough, or bringing up sputum.

This drug may lower your red blood cell count. If this occurs, it will usually happen a few months after starting treatment. A low red blood cell count (known as anemia) can cause shortness of breath, or make you feel weak or tired all the time. Your doctor might give you medicines to help prevent or treat this condition, or you may need to get blood transfusions.

Do not get any immunizations (vaccines), either during or after treatment with this drug, without your doctor's OK. This drug may affect your immune system. This could make vaccinations ineffective, or even lead to serious infections if you get live vaccines during treatment or for some time afterward. Try to avoid contact with people who have recently received a live virus vaccine, such as the oral polio vaccine or smallpox vaccine. Check with your doctor about this.

Possible side effects

You will probably not have most of the following side effects, but if you have any talk to your doctor or nurse. They can help you understand the side effects and cope with them.

Common

  • Diarrhea
  • Nausea
  • Feeling tired or weak

Less common

  • Rash, itchy skin, or dry skin
  • Vomiting
  • Mild allergic reaction during or soon after the infusion (may include fever, headache, chills, nausea, vomiting, shortness of breath)*
  • Abdominal pain
  • Headache
  • Mouth sores
  • Swelling in the lining of the nose or mouth
  • Change in how things taste
  • Lowered white blood cell count with increased risk of infection*
  • Upper respiratory infection, such as a cold
  • Fever
  • Infections around the fingernails or toenails

Rare

  • Serious allergic reaction, which may include trouble breathing, dizziness, shock, tightness in the throat, swelling of the face, mouth, tongue, or eyes*
  • Damage to the heart (may cause chest pain, coughing, trouble breathing, or swelling in legs or ankles)*
  • Lowered red blood cell count*

*See the “Precautions” section for more detailed information.

There are other side effects not listed above that can also occur in some patients. Tell your doctor or nurse if you develop these or any other problems.

FDA approval

Yes – first approved in 2012.

Disclaimer: This information does not cover all possible uses, actions, precautions, side effects, or interactions. It is not intended as medical advice, and should not be relied upon as a substitute for talking with your doctor, who is familiar with your medical needs.


Last Medical Review: 06/14/2012
Last Revised: 06/14/2012