Pertuzumab available for HER2-positive breast cancer
Pertuzumab, a new breast cancer treatment for those with advanced human epidermal growth factor (HER)2-positive disease, is now available in the UK.
Marketed by Roche as Perjeta, pertuzumab is indicated for use in combination with trastuzumab and docetaxel in adults with previously untreated advanced HER2-positive breast cancer.
It is a monoclonal antibody and is the first in a new class of personalised treatments known as HER2 dimerisation inhibitors. It works by preventing the HER2 receptor from pairing with any other HER family receptors, including epidermal growth factor receptor, HER3 and HER4. As a result, pertuzumab inhibits ligand-initiated intracellular signalling through two major signal pathways, leading to inhibited growth and, ultimately, cell death. It works synergistically with trastuzumab to provide a double blockade of HER2 signalling.
Approval of Perjeta was based on the results of a phase III study (n=808), which showed that pertuzumab in combination with trastuzumab and docetaxel increased progression-free survival by 6.1 months compared with trastuzumab and docetaxel alone (median PFS 18.5 versus 12.4 months, hazard ratio 0.62; P<0.0001).
The most common side effects were diarrhoea, alopecia, neutropenia, nausea and fatigue. However, pertuzumab was not associated with a higher incidence of cardiac side effects or left ventricular dysfunction compared with trastuzumab and docetaxel alone.
Pertuzumab is given intravenously by infusion every three weeks and should not be administered as an intravenous push or bolus.
Action: Recombinant humanised monoclonal antibody that blocks coupling of the HER2 receptor with other HER receptors
Dose: Initial loading dose 840mg administered as a 60-minute intravenous infusion, followed every three weeks by a maintenance dose of 420mg administered over 30 to 60 minutes
NHS list price: One vial (420mg), £2,395
Legal category: POM
Citation: The Pharmaceutical Journal DOI: 10.1211/PJ.2013.11118706
Recommended from Pharmaceutical Press