Introduction

Pertuzumab (trade name: Perjeta) has been approved in Germany since July 2015 for the treatment of HER2-positive, locally advanced, inflammatory, or early breast cancer in adults who have a high risk of recurrence. The drug is used in preparation for surgery (neoadjuvant therapy). Since April 2018, pertuzumab has also been approved as supportive (adjuvant) therapy after surgery to treat HER2-positive, early breast cancer with a high risk of recurrence.

The growth of tumor cells in breast cancer is influenced by various factors. These include a certain protein on the surface of the cancer cells called the HER2 receptor (human epidermal growth factor receptor). HER2 receptors respond to growth signals and trigger tumor growth. If there are a large number of these receptors on the cells of a breast tumor, it is called HER2-positive breast cancer. HER2-positive breast cancer grows relatively fast, and recurrences are more likely.

Pertuzumab is combined with the drug trastuzumab and chemotherapy. Both pertuzumab and trastuzumab bind to the HER2 receptor, blocking it and inhibiting the growth of the cancer cells.

Application

Pertuzumab enters the bloodstream directly through a drip into a vein (an intravenous infusion).

The first infusion contains 840 mg of pertuzumab and takes about an hour. Further infusions contain 420 mg of pertuzumab and take 30 to 60 minutes. The infusions are given every three weeks. The overall duration of the treatment depends on various things, like the type of breast cancer, the course of the disease, at what stage the surgery was performed, and how it is tolerated.

Other treatments

The possible standard treatments include combination therapy with the drugs trastuzumab, a taxane (paclitaxel or docetaxel), and where necessary an anthracycline (doxorubicin or epirubicin).

Assessment

In 2018, the Institute for Quality and Efficiency in Health Care (IQWiG, Germany) looked into the advantages and disadvantages of pertuzumab in combination with trastuzumab and docetaxel for women with HER2-positive, early breast cancer when compared with the standard treatments. The manufacturer provided one study on pertuzumab as neoadjuvant treatment and one study on pertuzumab as adjuvant treatment:

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More information

This information summarizes the main results of a review produced by the Institute for Quality and Efficiency in Health Care (IQWiG, Germany). The review was commissioned by the German Federal Joint Committee (G-BA) as part of the “early benefit assessment of medications.” On the basis of the review and the hearings received, the G-BA passed a resolution on the added benefit of pertuzumab (Perjeta).