Pertuzumab

(Perjeta®)

Perjeta®

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Drug updated on 4/15/2024

Dosage FormInjection (intravenous; 420 mg/14 mL)
Drug ClassHER2/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
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  • 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 TitleYearSource
Perjeta (pertuzumab) Prescribing Information.2021Genentech Inc., South San Francisco, CA

Systematic Reviews / Meta-Analyses

Document TitleYearSource
Efficacy and safety of first-line therapy in patients with HER2-positive advanced breast cancer: a network meta-analysis of randomized controlled trials2024Journal of Cancer Research and Clinical Oncology
Intrathecal trastuzumab versus alternate routes of delivery for HER2-targeted therapies in patients with HER2+ breast cancer leptomeningeal metastases.2023Breast (Edinburgh, Scotland)
Pathologic complete response achieved in early-stage HER2-positive breast cancer after neoadjuvant therapy with trastuzumab and chemotherapy vs. trastuzumab, chemotherapy, and pertuzumab: a systematic review and meta-analysis of clinical trials.2023Cureus
Evaluation of HER-2 positive breast cancer treated with dual-targeted treatment of trastuzumab plus pertuzumab. 2023Immunopharmacology and Immunotoxicology
Landscape of neoadjuvant therapy in HER2-positive breast cancer: a systematic review and network meta-analysis. 2023European Journal of Cancer
Identifying the optimal therapeutics for patients with hormone receptor-positive, HER2-positive advanced breast cancer: a systematic review and network meta-analysis. 2023ESMO Open
Efficacy and safety of treatment with or without pertuzumab for HER2-positive breast cancer: A meta-analysis. 2023Medicine
Dual neoadjuvant blockade plus chemotherapy versus monotherapy for the treatment of women with non-metastatic HER2-positive breast cancer: a systematic review and meta-analysis. 2023Clinical & Translational Oncology
Axillary downstaging and the impact of clinical axillary status on efficacy of neoadjuvant therapy for HER2-positive breast cancer: A network meta-analysis. 2023Technology in Cancer Research and Treatment
Neoadjuvant treatment with HER2-targeted therapies in HER2-positive breast cancer: a systematic review and network meta-analysis. 2022Cancers
Pertuzumab combined with trastuzumab compared to trastuzumab in the treatment of HER2-positive breast cancer: A systematic review and meta-analysis of randomized controlled trials. 2022Frontiers in Oncology
Determining the optimal (neo)adjuvant regimen for human epidermal growth factor receptor 2-positive breast cancer regarding survival outcome: A network meta-analysis. 2022Frontiers in Immunology
Neoadjuvant and adjuvant treatment of patients with HER2-positive early breast cancer. 2022Breast
Efficacy of second-line treatments for patients with advanced human epidermal growth factor receptor 2 positive breast cancer after trastuzumab-based treatment: a systematic review and Bayesian network analysis.2021Journal of Cancer
Efficacy of tucatinib for HER2-positive metastatic breast cancer after HER2-targeted therapy: a network meta-analysis. 2021Future Oncology
Systematic review and meta‑analysis of febrile neutropenia risk with TCH(P) in HER2‑positive breast cancer. 2021Breast Cancer Research and Treatment
Pertuzumab cardiotoxicity in patients with HER2-positive cancer: a systematic review and meta-analysis. 2021CJC Open
Efficacy and safety of anti-HER2 agents in combination with chemotherapy for metastatic HER2-positive breast cancer patient: a network meta-analysis. 2021Frontiers in Oncology
Efficacy and safety of pyrotinib versus T-DM1 in HER2+ metastatic breast cancer patients pre-treated with trastuzumab and a taxane: a Bayesian network meta-analysis. 2021Frontiers in Oncology
Prolonged responses With trastuzumab emtasine treatment of human epidermal growth factor receptor 2-positive metastatic breast cancer refractory to trastuzumab and pertuzumab: systematic review of evidence. 2021Clinical Breast Cancer
Meta-analysis of HER2-enriched subtype predicting the pathological complete response within HER2-ositive breast cancer in patients who received neoadjuvant treatment. 2021Frontiers in Oncology
The efficacy and safety of additional anti-HER2-targeting drugs in the treatment of HER2-positive advanced breast cancer: a meta-analysis. 2020Anticancer Agents in Medicinal Chemistry
Evaluating the clinical effectiveness and safety of various HER2-targeted regimens after prior taxane/trastuzumab in patients with previously treated, unresectable, or metastatic HER2-positive breast cancer: a systematic review and network meta-analysis. 2020Breast Cancer Research and Treatment
Dual HER2 blockade versus a single agent in trastuzumab-containing regimens for HER2-positive early breast cancer: a systematic review and meta-analysis of randomized controlled trials. 2020Journal of Oncology
A network meta-analysis on the efficacy of HER2-targeted agents in combination with taxane-containing regimens for treatment of HER2-positive metastatic breast cancer. 2020Breast Cancer
Efficacy and safety of HER2 inhibitors in combination with or without pertuzumab for HER2-positive breast cancer: a systematic review and meta-analysis.2019BMC Cancer
Pertuzumab in the treatment of HER2-positive breast cancer: an evidence-based review of its safety, efficacy, and place in therapy. 2019Core Evidence

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