Perjeta and Herceptin

By Jasmine Shukla

Last updated 4/1/2021

Breast Cancer is the second most common form of cancer (in women), after skin cancer, and affects 1 in 8 women. Breast cancer impacts a patient's physical, mental, and emotional well being while also affecting those who are caring for them. Women suffering or recovering from breast cancer often find it difficult to lead a normal life and struggle to revert back to their life before they were diagnosed with this life-threatening disease. This struggle stems from the severe and excruciating treatments that often accompany breast cancer, even when patients know that these treatments are mandatory for survival.

In the past few years, however, the pattern of treatment and chances of recovery have been bolstered significantly due to the innovations of several useful drugs, medications and therapies. Perjeta, Herceptin, and at times, a combination of both can be successfully applied - treatments for those diagnosed with breast cancer.

Perjeta Background

Perjeta (Pertuzumab) is a prescription medicine approved for use in combination with Herceptin and chemotherapy for use prior to surgery in patients with HER2-positive, or early stage breast cancer. Perjeta can also be prescribed for use after surgery has taken place in order to prevent the recurrence of HER2-positive breast cancer - as the risk is quite high during this period. The specifications of both these drugs mainly focuses on stopping the growth of cancer cells right from the beginning.

Herceptin Background

Herceptin (Trastuzumab), is an application used as a medication against HER2-positive breast cancer both during the early and/or advanced/metastatic stage for stopping the growth of cancer. It has been approved by the US Food and Drug Department. Herceptin, in the early stages, can be employed as a regimen (prescribed course medical treatment) portion along with chemotherapy regimen which contains an anthracycline for lessening the risk of breast cancer recurring.

The Path to Perjeta

The drugs mentioned here are monoclonal antibodies, i.e they bind to specific cells or tissues within the body and function as immunotherapy for the patients. Herceptin was introduced about 15 years ago in order to target HER2 as a clinical treatment for patients with breast cancer. However, Herceptin alone was not proving to be sufficient enough to fight against it as most patients with HER2-positive metastatic breast cancer displayed a progression in their disease rather than an improvement. This result indicated that new therapies were needed which, as a consequence, lead to the invention of Perjeta.

Perjeta and Herceptin Combination

Perjeta, together with Herceptin, plus Docetaxel (a chemotherapy medication applicable for treating a number of cancers like breast, skin, neck, etc.) has become a benchmark for HER2 positive metastatic breast cancer patients. Perjeta, when administered with Herceptin provides synergistic activity as per clinical and preclinical data.

Perjeta and Herceptin Dose:

Perjeta and Herceptin are administered every 3 weeks in the following amounts of doses:

2 ways of giving doses of both of these drugs to the patients-

1. Loading Dose, an initial higher dose given at the start of any particular treatment course before dropping down to lower regular dose, also helpful to drugs that requires elimination from the body at a slower rate.

For Perjeta, Loading dose: 840mg with an infusion time of 60 minutes (volume with respect to flow rate).

For Herceptin, Loading dose: 8mg/kg with an infusion time of 90 minutes

Chemotherapy varies as per the regimen.

2. Subsequent Doses, the normal/regular once taken periodically.

For Perjeta, Subsequent dose: 420mg with an infusion time of 30-60 minutes

For Herceptin, Subsequent dose: 6mg/kg with an infusion time of 30-90 minutes

Chemotherapy varies as per the regimen.

Herceptin is a 1 year treatment, taken every three weeks, resulting in about 17 or 18 infusions. Side effects are pretty well tolerated, though you may experience fatigue, loss of appetite, nausea, headaches, runny nose, sore throat.

Perjeta and Herceptin Cost:

Prices of these drugs' doses are around $7.93/mg and $6.43/mg for Perjeta and Herceptin respectively. As observed these treatments normally have significant expenses that are unaffordable to most patients falling under low income groups. However, there are certain insurance plans available that help cover these expenses to some rate. It is usually advised to talk your respected doctor regarding the cost and expenses and coverage of insurance properly and satisfactorily. In addition, both of these drugs also have certain side effects (which are elaborated on in another blog (Side Effects of Perjeta), and therefore must be taken under medical observation and after proper consultations.