pertuzumab + trastuzumab at a glance
Medicine class
Dual HER2-targeted monoclonal antibody therapy
Licensed uses
Selected HER2-positive early, locally recurrent unresectable or metastatic breast cancers
Administration
A healthcare professional injects it under the skin of the thigh
Important monitoring
HER2 status and heart function must be assessed
What is pertuzumab + trastuzumab used for?
Licensed uses for this fixed subcutaneous combination are:
With chemotherapy before surgery for adults with HER2-positive locally advanced, inflammatory or early breast cancer at high risk of recurrence.
With chemotherapy after surgery for adults with HER2-positive early breast cancer at high risk of recurrence.
With docetaxel for adults with HER2-positive metastatic or locally recurrent unresectable breast cancer who have not previously received anti-HER2 treatment or chemotherapy for metastatic disease.
How does pertuzumab + trastuzumab work?
Both antibodies bind HER2 at different sites. Pertuzumab limits pairing of HER2 with related receptors, while trastuzumab suppresses other HER2-driven survival signals. Together they reduce tumour-cell signalling and can help the immune system destroy HER2-overexpressing cells. Vorhyaluronidase alfa helps the combination disperse after injection under the skin.
pertuzumab + trastuzumab preparations and strengths
Injection
Route: Parenteral
Strengths: 600 mg + 600 mg, 1200 mg + 600 mg
How to take pertuzumab + trastuzumab
A trained healthcare professional gives the solution as a slow injection under the skin of the thigh. Treatment starts in a clinical setting. After it has been safely established, a clinician may consider administration elsewhere, including at home, by a healthcare professional.
Alternate between the left and right thigh.
Avoid skin that is red, bruised, tender or hard.
Other injections under the skin should preferably use a different site.
Observation after administration is needed for injection-related or allergic reactions.
Food does not affect administration because this is an injection.
pertuzumab + trastuzumab side effects
Common or expected effects
- Diarrhoea, nausea, vomiting or abdominal discomfort
- Tiredness, weakness, fever or reduced appetite
- Hair loss, particularly when chemotherapy is also used
- Joint or muscle pain and headache
- Rash, dry or itchy skin and nail changes
- Pain or redness at the injection site
- Low blood-cell counts and increased infection risk, particularly with chemotherapy
- Numbness, tingling or altered taste
Get urgent medical advice
- Severe allergic or injection-related reaction, including breathing difficulty, swelling, wheeze or collapse
- Heart dysfunction or heart failure, which may cause breathlessness, swelling or rapid weight gain
- Fever with low white-cell counts or other signs of serious infection
- Severe or persistent diarrhoea with dehydration
- New or worsening breathlessness, cough or other possible lung inflammation
pertuzumab + trastuzumab in pregnancy
Pertuzumab and trastuzumab should usually be avoided during pregnancy because they may harm fetal kidney development and reduce amniotic fluid. Effective contraception is advised during treatment and for 7 months afterwards. Contact the oncology and maternity teams promptly if pregnancy occurs during this period; specialist multidisciplinary monitoring may be required.
pertuzumab + trastuzumab while breastfeeding
Breastfeeding is not recommended during treatment or for at least 7 months afterwards because transfer into milk and possible harm to the infant are uncertain. Discuss feeding options with the oncology and maternity teams.
pertuzumab + trastuzumab interactions
Formal interaction studies of the fixed combination are limited. Review all prescribed, over-the-counter and complementary products with the oncology team.
Anthracyclines, such as doxorubicin or epirubicin
These can add to cardiac toxicity, so treatment sequencing, previous exposure and heart function require careful assessment.
Taxanes, such as docetaxel or paclitaxel
Combined treatment increases the importance of monitoring for febrile neutropenia, diarrhoea and lung inflammation.
Gemcitabine or vinorelbine
These treatments may add to the risk of interstitial lung disease, requiring caution if respiratory symptoms develop.
Common questions about pertuzumab + trastuzumab
Answers are fully visible for fast scanning and source review.
Why are pertuzumab and trastuzumab used together?
They bind different parts of HER2 and block complementary growth signals, producing broader HER2 inhibition than either mechanism alone.
How do doctors know whether pertuzumab and trastuzumab are suitable?
A tumour sample must show HER2 positivity using a validated laboratory test.
Is pertuzumab plus trastuzumab chemotherapy?
No. Both components are targeted monoclonal antibodies, although the licensed uses commonly require chemotherapy as part of the treatment plan.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.