Early breast cancer treatment before surgery

For some people with early breast cancer, it may be beneficial to start treatment before having surgery. This is called neoadjuvant treatment.

Prior to surgery, PERJETA is approved for use in combination with Herceptin® (trastuzumab) and chemotherapy in adults with HER2+, locally advanced, inflammatory, or early stage breast cancer (tumor greater than 2 cm in diameter or node positive). PERJETA should be used as part of a complete treatment regimen for early breast cancer.

One of the goals of neoadjuvant treatment for early breast cancer is to help reduce or get rid of cancer cells before surgery.

Keep in mind that not all cancers respond to neoadjuvant treatment. In addition, some people may experience serious or common side effects while receiving neoadjuvant treatment.

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Starting PERJETA-based therapy before surgery

People who are eligible may receive 3-6 cycles (9-18 weeks) of PERJETA and Herceptin before surgery.

PERJETA Pre-Surgery Neoadjuvant and Adjuvant

You will also be given chemotherapy, but the dosing schedule and number of cycles will depend on which type of chemotherapy you receive.

Cycle: A course of treatment that is repeated on a regular schedule with periods of rest in between. For example, PERJETA + Herceptin is given once every 3 weeks. That is one cycle.

*Adjuvant treatment may vary.
†Unless side effects become too difficult to manage, or the cancer comes back sooner.

Continuing PERJETA based therapy may be an option. Learn more about adjuvant treatment
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Side effects may occur with PERJETA

What are the possible side effects of PERJETA? PERJETA may cause serious side effects, including:

  • PERJETA can cause heart problems, including those without symptoms (such as reduced heart function) and those with symptoms (such as congestive heart failure)
  • Receiving PERJETA during pregnancy can cause the death of an unborn baby and birth defects

Who should not take PERJETA?
PERJETA should not be used in patients who are allergic to pertuzumab or to any of the ingredients in PERJETA.

What are the other possible side effects of PERJETA? Serious side effects of PERJETA may also include:
Possible serious and sometimes fatal side effects of PERJETA include infusion-related reactions and severe allergic reactions (hypersensitivity reactions/anaphylaxis).

See additional Important Safety Information below.

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How your doctor will tell if your cancer is responding to neoadjuvant treatment

Breast tissue and nodes will be removed during surgery. A pathologist will then look at them to see if cancer cells can be detected. If none are present, this is called a pathological complete response (pCR). pCR is not a cure.

In a clinical trial with certain people with HER2+ early breast cancer, neoadjuvant PERJETA + Herceptin + docetaxel was compared to Herceptin + docetaxel.

Almost twice as many people who got PERJETA + Herceptin-based therapy before surgery had no detectable cancer cells in the lymph nodes and breast tissue removed during surgery (39.3%), compared with people who received the other treatment (21.5%).

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How PERJETA is given

See how PERJETA + Herceptin-based therapy is given and what you may expect during your infusion.

About the infusion

Have additional questions?

Discover information and resources to help you have an informative conversation with your doctor.

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PERJETA® (pertuzumab) is a prescription medicine approved for use in combination with trastuzumab and chemotherapy for use prior to surgery (neoadjuvant treatment) in adults with HER2-positive, locally advanced, inflammatory, or early stage breast cancer as part of a complete treatment regimen for early breast cancer.

Perjeta is given through an IV infusion in a healthcare setting. The initial dose is 840 mg infused over 60 minutes, followed every three weeks by a dose of 420 mg infused over 30-60 minutes.

Serious side effects of Perjeta include heart problems, death of an unborn baby, and birth defects. Perjeta should not be used in patients who are allergic to Perjeta or to any of the ingredients in Perjeta. Other possible serious and sometimes fatal side effects include infusion-related reactions and severe allergic reactions. The most common side effects of Perjeta when given with trastuzumab and chemotherapy prior to surgery for early breast cancer include constipation, damage to the nerves, nausea, vomiting, diarrhea, low levels of red and white blood cells, thrombocytopenia, weakness or feeling tired, rash, hair loss, headache, mouth sores or blisters, and muscle pain.

Important Safety Information

What is PERJETA?

PERJETA® (pertuzumab) is a prescription medicine approved for use in combination with trastuzumab and chemotherapy for:

  • Use prior to surgery (neoadjuvant treatment) in adults with HER2-positive, locally advanced, inflammatory, or early stage breast cancer as part of a complete treatment regimen for early breast cancer
  • Use after surgery (adjuvant treatment) in adults with HER2-positive early breast cancer that has a high likelihood of coming back

PERJETA® (pertuzumab) is a prescription medicine approved for use in combination with trastuzumab and docetaxel in adults who have HER2-positive breast cancer that has spread to different parts of the body (metastatic) and who have not received prior anti-HER2 therapy or chemotherapy for metastatic breast cancer.

What are the possible side effects of PERJETA?

PERJETA may cause serious side effects, including:

PERJETA can cause heart problems, including those without symptoms (such as reduced heart function) and those with symptoms (such as congestive heart failure)

  • Your doctor will run tests to monitor your heart function before and during treatment
  • Based on these tests, your treatment may be interrupted or discontinued
  • Contact a health care professional immediately if you experience any of the following: new onset or worsening shortness of breath, cough, swelling of the ankles/legs, swelling of the face, palpitations, weight gain of more than 5 pounds in 24 hours, dizziness or loss of consciousness

Receiving PERJETA during pregnancy can cause the death of an unborn baby and birth defects

  • Your doctor will verify your pregnancy status before treatment begins
  • Birth control should be used while receiving PERJETA and for 7 months after your last dose of PERJETA. If you are a mother who is breastfeeding, you should talk with your doctor about either stopping breastfeeding or stopping PERJETA
  • If you think you may be pregnant, you should contact your healthcare provider immediately
  • If you are exposed to PERJETA during pregnancy, or become pregnant while receiving PERJETA or within 7 months following the last dose of PERJETA with trastuzumab, you are encouraged to report PERJETA exposure to Genentech at 1-888-835-2555

Who should not take PERJETA?

PERJETA should not be used in patients who are allergic to pertuzumab or to any of the ingredients in PERJETA.

What are the other possible side effects of PERJETA?

Serious side effects of PERJETA may also include:

  • Infusion-related reactions: PERJETA is given as an infusion. PERJETA can cause serious infusion-related reactions, some fatal. When given alone, the most common infusion-related reactions were fever, chills, fatigue, headache, weakness, hypersensitivity, and vomiting. When given with trastuzumab and docetaxel, the most common infusion-related reactions were fatigue, altered taste, hypersensitivity, muscle pain, and vomiting
  • Severe allergic reactions: PERJETA can cause hypersensitivity reactions, including anaphylaxis and fatal events. Contact a health care professional immediately if you experience any of the following symptoms: swelling of the face, lips or tongue, trouble breathing, or chest pains

The most common side effects of PERJETA include:

The most common side effects of PERJETA when given with trastuzumab and chemotherapy prior to surgery for early breast cancer include:

  • Constipation
  • Damage to the nerves (numbness, tingling, pain in hands/feet)
  • Diarrhea
  • Fatigue
  • Hair loss
  • Headache
  • Decreased red blood cell counts, white blood cell counts, and platelet counts
  • Mouth sores or blisters
  • Nausea
  • Muscle pain
  • Vomiting
  • Weakness

The most common side effects of PERJETA when given with trastuzumab and chemotherapy after surgery for early breast cancer include:

  • Diarrhea
  • Nausea
  • Hair loss
  • Fatigue
  • Damage to the nerves (numbness, tingling, pain in hands/feet)
  • Vomiting

The most common side effects of PERJETA when given with trastuzumab and docetaxel for metastatic breast cancer include:

  • Diarrhea
  • Hair loss
  • Low levels of white blood cells with or without fever
  • Nausea
  • Fatigue
  • Rash
  • Damage to the nerves (numbness, tingling, pain in hands/feet)

Side effects may vary based on chemotherapy regimen. These are not all the possible side effects of PERJETA. Call your healthcare provider for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088 or www.fda.gov/medwatch. You may also report side effects to Genentech at 1-877-436-3683.

Before you take PERJETA, tell your healthcare provider about all of your medical conditions, including if you:

  • Have a history of heart disease
  • Are pregnant or plan to become pregnant. PERJETA can harm your unborn baby
  • Are breastfeeding or plan to breastfeed. It is not known if PERJETA passes into your breastmilk

Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements.

Please see the full Prescribing Information for additional Important Safety Information, including most serious side effects.

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