SELECT METASTATIC BREAST CANCER DOSING AND ADMINISTRATION


Patient selection

Assessment of HER2 protein overexpression and HER2 gene amplification should be performed using FDA-approved tests specific for breast cancer by laboratories with demonstrated proficiency.1

MBC eligibility

To begin PERJETA and Herceptin® (trastuzumab) and docetaxel, patients must have HER2+ metastatic breast cancer (MBC), and not have previously received anti-HER2 therapy or chemotherapy for MBC.1

Please see the full Prescribing Information for complete dosing and administration, including dose considerations, dose modifications, preparation, storage, and handling. You can also download the PERJETA Dosing & Administration Guide.

Recommended dosing

PERJETA and Herceptin are administered every 3 weeks1

PERJETA is a fixed dose, regardless of body weight. Administer 840 mg loading dose, 420 mg for subsequent cycles; Herceptin dosing: 8 mg/kg loading dose, 6 mg/kg for subsequent cycles.

Dosing considerations

Dose sequencing1

  • PERJETA, Herceptin, and taxanes should be administered sequentially
    • PERJETA and Herceptin can be given in any order, and taxane should be administered after PERJETA and Herceptin
  • An observation period of 30 to 60 minutes is recommended after each PERJETA infusion and before commencement of any subsequent infusion of Herceptin or chemotherapy

If a delayed or missed dose of PERJETA occurs1

Dose interruption or discontinuation of treatment1

  • PERJETA should be discontinued if Herceptin treatment is discontinued
  • Dose reductions are not recommended for PERJETA
  • For chemotherapy dose modifications, see their respective prescribing information
  • If a significant infusion-associated reaction occurs, slow or interrupt the infusion and administer appropriate medical therapies
    • The infusion should be discontinued immediately if the patient experiences a serious hypersensitivity reaction

PERJETA and Herceptin should be continued until disease progression or unmanageable toxicity.1

MBC docetaxel regimens1,2

When administered with PERJETA, the recommended initial dose of docetaxel is 75 mg/m2 administered as an IV infusion.1

  • In the CLEOPATRA trial, it was recommended that docetaxel be administered for a minimum of 6 cycles1,2
    • The docetaxel dose could be decreased by 25% due to toxicity or increased to 100 mg/m2 in those patients who could tolerate this dose
    • Fewer than 6 cycles were allowed for unmanageable toxicity
    • Comparable docetaxel exposure between the 2 treatment arms in CLEOPATRA2
      • Docetaxel was administered for a median of 8 cycles in both treatment arms
  • If docetaxel is discontinued, PERJETA and Herceptin may be continued on their own1,2

Patient monitoring1

  • Close observation of the patient is recommended for 30-60 minutes after each PERJETA infusion and before any subsequent infusion of Herceptin or chemotherapy1
  • If a significant infusion-associated reaction occurs, slow or interrupt the infusion and administer appropriate medical therapies
  • The infusion should be discontinued immediately if the patient experiences a serious hypersensitivity reaction

Dose modifications for left ventricular dysfunction in MBC

Cardiac monitoring

Please see the full Prescribing Information for complete dosing and administration, including dose considerations, dose modifications, preparation, storage, and handling. You can also download the PERJETA Dosing & Administration Guide.

References