Perjeta (Pertuzumab) for Breast Cancer

What Members Say Top Tips Side Effects FAQs

Perjeta (pertuzumab) is a prescription medication approved by the U.S. Food and Drug Administration (FDA) to treat adults with HER2-positive breast cancer.

What Members Say

MHT logo These insights are based on 1,729 comments about Perjeta from MyBCTeam members. These are the experiences of a small number of individuals and are not meant to be medical advice.

Benefits:

Maintenance treatment every three weeks can feel more manageable than earlier chemo combinations.
Infusions often feel shorter and easier once docetaxel or carboplatin ends.
Scans sometimes show tumor shrinkage or no evidence of active disease.

Considerations:

Diarrhea is very common and can be severe enough to need extra treatment.
Fatigue can continue during maintenance and affect daily activities.
Heart function needs regular monitoring because treatment can lower ejection fraction.

How Perjeta Works and How It’s Taken

Perjeta is a human epidermal growth factor receptor 2 (HER2)-targeted medicine. HER2 is a protein that can help some breast cancer cells grow.

Perjeta attaches to HER2. It helps block HER2 from pairing with other growth signals on cancer cells. This can slow cancer cell growth, help cancer cells die, and help the immune system attack cancer cells.

Doctors prescribe Perjeta when certain adults have HER2-positive breast cancer. How it is used depends on the type and stage of breast cancer.

Perjeta may be used:

With trastuzumab and docetaxel for HER2-positive metastatic breast cancer. Metastatic means the cancer has spread. This use is for adults who have not already received anti-HER2 treatment or chemotherapy for metastatic disease.
With trastuzumab and chemotherapy before surgery for HER2-positive locally advanced, inflammatory, or early-stage breast cancer. For early-stage disease, the tumor must be larger than 2 centimeters or have cancer in the lymph nodes.
With trastuzumab and chemotherapy after surgery for HER2-positive early breast cancer that has a high risk of coming back.

Perjeta is given as an intravenous (IV) infusion. This means it is given through a vein.

Typical Dosing for Breast Cancer

The first dose is 840 milligrams. After that, the dose is 420 milligrams every three weeks.

For early breast cancer, Perjeta is used with trastuzumab and chemotherapy. Treatment may continue for a total of one year, up to 18 cycles, unless the cancer comes back or side effects become too hard to manage.

For metastatic breast cancer, Perjeta is used with trastuzumab and docetaxel. Perjeta and trastuzumab may continue until the cancer gets worse, the person chooses to stop treatment, or side effects become unacceptable.

Doctors may slow or stop an infusion if certain serious reactions happen. They may also withhold or stop Perjeta if heart function decreases by certain amounts.

This information is based on the prescribing information, but your healthcare provider may tailor your treatment plan. Always follow their guidance.

Top Advice From Members on Perjeta

MHT logo These insights are based on 1,729 comments about Perjeta from MyBCTeam members.

Members who use Perjeta often say it helps to plan ahead for side effects, especially diarrhea, fatigue, and heart monitoring. Many also say the treatment feels more manageable when they stay in close touch with their oncology team and know what to expect once chemotherapy is finished and Perjeta continues with trastuzumab.

1

Keep anti-diarrhea supplies and fluids ready.
“The worst was diarrhea, and she took a LOT of Imodium and drank lots of water. We always knew the second week would be when it would hit.”
2

Tell your care team quickly about side effects or new symptoms.
“Finally decided that I don’t have to feel like crap. I called my oncologist today and said let’s try another anti-nausea Rx. Got an Rx for Zofran, and already it’s better.”
3

Keep up with heart monitoring during treatment.
“I’m having echocardiograms every three months to check that the Herceptin (trastuzumab) and Perjeta haven’t caused any damage to my heart.”
4

Track when side effects happen after each cycle.
“After each treatment, days 4-9 are a little unpleasant: indigestion, tastebuds out of whack, tongue extremely sensitive, some joint pain, loss of appetite.”

Connect with others who understand life with breast cancer. Join MyBCTeam for free.

Perjeta Side Effects

In clinical trials, the most common side effects of Perjeta varied by treatment regimen. These side effects occurred in more than 30 percent of people in at least one breast cancer treatment setting.

These side effects include:

Diarrhea
Alopecia (hair loss)
Neutropenia (low white blood cell counts)
Nausea
Fatigue
Rash
Peripheral neuropathy (numbness, tingling, or pain in the hands or feet)
Vomiting
Thrombocytopenia (low platelet counts)
Anemia (low red blood cell counts)
Constipation
Headache
Asthenia (weakness and lack of energy)
Mucosal inflammation (inflammation and soreness in the mouth or digestive tract)
Myalgia (muscle pain)

Serious Side Effects and Warnings

Perjeta can cause serious side effects that may require immediate medical attention. These include:

Left ventricular dysfunction — Heart problems, including heart failure, can occur.
Embryo-fetal toxicity — Exposure during pregnancy can harm your baby, including causing birth defects or death.
Serious infusion-related reactions — Serious reactions can happen during or after an infusion.
Severe allergic reactions — These can include anaphylaxis and angioedema.

Get medical help right away if you think you are having a serious reaction.

What To Know Before Taking Perjeta

Before starting Perjeta, your doctor will test or check for:

Heart function, including left ventricular ejection fraction (LVEF)
Whether your tumor is HER2-positive using an FDA-approved test
Pregnancy status if you can become pregnant

Tell your doctor if you have any allergies to Perjeta or any ingredients in Perjeta.

Tell your doctor about all medicines you take, including prescription drugs, over-the-counter medicines, and supplements.

Do not take Perjeta if you have had a serious allergic reaction to Perjeta or any of its ingredients.

If you miss a dose, contact your doctor as soon as possible. If it has been less than six weeks since your last dose, the usual 420-milligram dose should be given as soon as possible. If it has been six weeks or more, Perjeta should be restarted with the 840-milligram loading dose.

Perjeta can harm your baby if you are pregnant. Your doctor should verify pregnancy status before you start treatment. Females who can become pregnant should use effective birth control during treatment and for seven months after the last dose of Perjeta given with trastuzumab.

It is not known whether Perjeta passes into human breast milk. Because Perjeta may stay in the body after treatment ends, consider the seven-month washout period before breastfeeding.

Community FAQs

These answers are fact-checked by our editorial staff.

How effective is Perjeta?

In a study of HER2-positive metastatic breast cancer, people who received Perjeta with trastuzumab and docetaxel had a median progression-free survival of 18.5 months. This means half of the people went longer than 18.5 months without the cancer getting worse. People who received trastuzumab and docetaxel without Perjeta had a median progression-free survival of 12.4 months.

Median overall survival was 56.5 months with Perjeta, compared with 40.8 months without it.

In an early breast cancer study, 39.3 percent of people who received Perjeta plus trastuzumab and docetaxel had a pathologic complete response. This means no invasive cancer was found in the breast and lymph nodes at surgery. This compared with 21.5 percent of people who received trastuzumab and docetaxel without Perjeta.

What tests or monitoring are needed with Perjeta for breast cancer?

Heart function monitoring is important with Perjeta because it can cause left ventricular dysfunction, including heart failure. Left ventricular ejection fraction should be checked before starting treatment and at regular intervals during treatment. Pregnancy status should also be verified before starting Perjeta in females of reproductive potential.