Class:
- HER2-targeted monoclonal antibody (humanized IgG1)
Mechanism of Action:
- Binds to the extracellular domain II of the HER2 receptor, blocking HER2 dimerization (especially HER2/HER3 heterodimers).
- This inhibits downstream signaling pathways involved in cell proliferation and survival.
- When combined with trastuzumab (which binds a different HER2 domain), it provides complementary and synergistic HER2 blockade.
Indications:
- HER2-positive early-stage breast cancer (neoadjuvant and adjuvant settings), usually combined with chemotherapy and trastuzumab.
- HER2-positive metastatic breast cancer, in combination with trastuzumab and chemotherapy.
Administration:
- Intravenous infusion, typically every 3 weeks, often given with trastuzumab and chemotherapy.
Key Toxicities:
- Cardiotoxicity (monitor left ventricular ejection fraction)
- Infusion-related reactions
- Diarrhea
- Rash
- Neutropenia (when combined with chemotherapy)
Pharmacist Considerations:
- Monitor cardiac function regularly due to risk of decreased LVEF.
- Counsel patients about possible infusion reactions and gastrointestinal side effects.
- Ensure coordination with chemotherapy regimens and supportive care measures.
- Assess for potential drug interactions, though minimal due to monoclonal antibody nature.
Synonyms
Perjeta