Brand Name: Perjeta
Generic Name: pertuzumab
Medication Class: monoclonal antibody
Similar Drugs: gemtuzumab (Mylotarg), alemtuzumab (Campath, Lemtrada), rituximab (Rituxan)
FDA Approval date: June 8, 2012, for HER2-positive metastatic breast cancer. September 30, 2013, for neoadjuvant breast cancer treatment.
What is Perjeta and its mechanism of action?
HER2 is a type of receptor found on normal cells and inside breast cancer cells. Women with HER2-positive breast cancer have too many HER2 receptors in their cancer cells. When HER2 receptors are activated, they make the cancer cell grow and divide. Perjeta is a humanized monoclonal antibody that mimics the antibodies the body naturally produces as part of the immune system’s response to viruses, bacteria, and other invaders. Perjeta works by attaching itself to HER2 receptors on breast cancer cells, preventing the cells from receiving the signals they need to grow. This slows or stops the spread of breast cancer.
What is Perjeta used for treating?
Perjeta is used for treating breast cancer that has an abundance of HER2 receptors. It is used with trastuzumab (Herceptin) and docetaxel as first-line treatment for metastatic breast cancer (cancer that has spread beyond its primary site) or as a neoadjuvant therapy. Neoadjuvant therapy is used to shrink the tumor prior to surgical removal.
How effective is Perjeta?
Eight hundred and eight women with HER2-positive metastatic breast cancer were randomized to receive Perjeta with trastuzumab plus docetaxel or placebo with trastuzumab plus docetaxel. Perjeta was given intravenously with a loading dose of 840 mg, followed by 420 mg every 3 weeks. Trastuzumab was given intravenously with a loading dose of 8 mg/kg, followed by 6 mg/kg every 3 weeks. Docetaxel was given as an infusion of 75 mg/m2 every 3 weeks for at least 6 cycles. In the group receiving Perjeta, there was a 41.8% death rate and 47.5% disease progression rate after 20 months of treatment versus a 54.4% death rate and 59.6% disease progression rate in the placebo group.
In 417 women with operable, advanced, or inflammatory HER2 positive breast cancer, Perjeta was tested as a neoadjuvant treatment in combination with trastuzumab and docetaxel. Perjeta was given intravenously as a loading dose of 840 mg, followed by 420 mg every 3 weeks for 4 cycles. Trastuzumab was given intravenously as a loading dose of 8 mg/kg, followed by 6 mg/kg every 3 weeks for 4 cycles (4 months). Docetaxel was given as an initial dose of 75 mg/m2 by intravenous infusion every 3 weeks for 4 cycles. In patients receiving Perjeta as part of their treatment, 39.3% of the breast tumors showed a favorable reduction, compared to only 21.5% in patients not receiving Perjeta.
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