Advances in cancer treatment have seen the development of medicines known as targeted or biological therapies which can help to slow the growth of cancer cells.
PERJETA is a targeted therapy which is used in the treatment of people with early (prior to surgery) and advanced (metastatic) HER2-positive breast cancer.
PERJETA is registered for use in New Zealand in early breast cancer before surgery (neoadjuvant treatment), but it is not publicly funded which means you have to pay for it.
PERJETA is a fully funded medicine for patients with HER2-positive advanced (metastatic) breast cancer who meet pre-defined criteria. You can find out more about PERJETA for metastatic or advanced HER2-positive breast cancer here.
You can find out more about PERJETA as neoadjuvant treatment on these pages. PERJETA is not suitable for everyone, so it’s important that you speak with your doctor about whether this medication may be right for you.
On these pages you can learn more about:
How Does PERJETA Work?
PERJETA, also known as pertuzumab, is given with Herceptin® (trastuzumab) and chemotherapy to block cancer growth signals and slow the spread of the cancer
PERJETA also sends signals to your immune system that cause it to attack the cancer.
PERJETA targets a different part of the HER2 protein so it works in a complementary way to Herceptin.
PERJETA for treating Early Breast Cancer before surgery
Treatment before surgery is also called neoadjuvant treatment. Your oncologist may choose neoadjuvant treatment to shrink the size of the tumour before surgery.
PERJETA in combination with Herceptin and chemotherapy is registered by MEDSAFE for use prior to surgery in patients with inflammatory or locally advanced HER2-positive early breast cancer.
The potential benefits of neoadjuvant treatment for breast cancer
Neoadjuvant treatment may:
- Help improve the chance that surgery will be successful
- Give more options for the type of surgery that can be performed
- Help reduce or eliminate cancer cells before surgery
- Show a healthcare team if certain therapies are likely to work after surgery
Treatment before surgery (neoadjuvant)
What type of treatment is given before surgery?
When medicines like chemotherapy, targeted therapy, or hormonal therapy are used to treat cancer before surgery, the treatment is called neoadjuvant therapy.
These are the key steps for an early breast cancer treatment plan for patients that are eligible for neoadjuvant therapy:
How will I know if neoadjuvant therapy has been effective?
A pathologist checks the breast tissue and nodes removed during surgery to see how well the treatment has worked. Neoadjuvant treatment works if cancer cells are not detected from the breast and lymph nodes. This is called a ‘pathological complete response’.
A pathological complete response is not a cure, but it can give some information about your cancer treatment plan.
How Can PERJETA Help Me?
PERJETA is registered by MEDSAFE for use prior to surgery in combination with Herceptin and chemotherapy for the neoadjuvant treatment of patients with inflammatory or locally advanced HER2-positive early breast cancer.
Registration was based on two clinical trials of more than 600 patients with HER2-positive early breast cancer who received neoadjuvant treatment with PERJETA, Herceptin, and chemotherapy
In one of these trials 46% of patients had a pathological complete response (pCR) when treated with PERJETA, Herceptin and chemotherapy, compared with 29% of patients treated with Herceptin and docetaxel.
How is PERJETA given for treatment before surgery?
PERJETA is given as an intravenous (IV) infusion, which means that the medicine is delivered through a needle that your nurse inserts into a vein.
If you haven’t received an infusion before, you can ask your doctor or nurse to explain this to you in more detail.
PERJETA is typically given every 3 weeks on the same day as Herceptin and chemotherapy. The number of infusions you will be given and infusion times may vary from person to person depending on how you respond to treatment.
Your First Infusion
The amount of medicine (dose) you are given, and how long each infusion will last, are different for the first and following infusions of PERJETA.
The medicines are given more slowly during your first visit. Your first dose of PERJETA will be given as an IV infusion over 60 minutes. You may be monitored for 30–60 minutes after your PERJETA infusion.
Your Subsequent Infusions
If the first infusion is well-tolerated, subsequent infusions may be given over 30 minutes. This will usually be followed by a 30 to 60 minute observation time.
The infusion may be slowed or interrupted if you experience side-effects or have an allergic reaction. Your doctor will decide on the infusion time that is right for you.
What does a complete treatment course look like?
PERJETA is a medicine that works with other medicines to fight cancer.
- Before surgery, PERJETA (P) is given with Herceptin (H) and chemotherapy
- After surgery, Herceptin is given to complete a total of one year of treatment (time before and after surgery).
What should I know if I am pregnant or thinking of getting pregnant?
Birth control should be used while receiving PERJETA and Herceptin and for 7 months after your last dose of Herceptin. If you are a mother who is breastfeeding, you should talk with your doctor.
Side Effects of PERJETA
PERJETA helps control the growth and spread of HER2-positive breast cancer but it may have some unwanted side-effects in some people.
All medicines can have side effects. Sometimes they are serious, most of the time they are not. You may need medical treatment if you get some of the side-effects.
Ask your medical team to answer any questions you may have.
Because PERJETA may be used with other medicines that treat breast cancer, it may be difficult for your doctor to tell whether the side-effects are due to PERJETA or due to the other medicines.
Your medical team is in the best position to help you manage any side-effects so be open with them about any symptoms you notice, whether you think they are caused by PERJETA or not.
For a full list of PERJETA side-effects, or if you want to find out more about PERJETA related side-effects, please look at the PERJETA Consumer Medicines Information. In the Consumer Medicines Information, look at:
- ‘Before you are given PERJETA’
- ‘While you are receiving PERJETA’, and
- ‘Side Effects’ sections.
Talking to Your Doctor About Whether PERJETA is Right for You
PERJETA for early breast cancer before surgery (neoadjuvant treatment) is not publicly funded which means you have to pay for it.
Speak with your doctor about your specific case and the pros and cons of PERJETA treatment.
If you’re not sure how to have this discussion with your doctor, we’ve developed a list of common questions which might help you. Have a look at these here.
Remember, PERJETA is not right for everyone and your doctor will need to ask you a number of questions to see if it’s suitable for you.
For more information on PERJETA, you might like to look at the following: