Perjeta (Pertuzumab) for Breast Cancer: Another Targeted Therapy Option

Introduction:

Breast cancer, one of the most common cancers diagnosed worldwide, has seen revolutionary advances in its treatment methodologies over the years[1]. Among the game-changers in this journey are targeted therapies---drugs designed to specifically attack cancer cells without harming normal cells. One such drug that has risen to prominence in recent years is Perjeta (Pertuzumab). This article dives deep into the workings, benefits, and considerations of using Pertuzumab as a treatment for breast cancer.

Understanding Targeted Therapies:

Targeted therapies are distinct from traditional chemotherapy. While chemotherapy attacks rapidly dividing cells indiscriminately (which includes both cancerous and some normal cells), targeted therapies are crafted to intervene with specific molecules that are involved in the growth, progression, and spread of cancer[2]. The precision of targeted therapies often results in fewer side effects compared to chemotherapy.

Perjeta (Pertuzumab): A Closer Look

Pertuzumab is a monoclonal antibody designed to target the HER2 receptor, a protein that can promote the growth of cancer cells. In some breast cancers, high levels of HER2 are present. With this high level of HER2, breast cancer can be more aggressive and less responsive to hormonal treatments but might be more responsive to drugs like Perjeta that target HER2[3].

Benefits and Indications:

1. Neoadjuvant Setting: Pertuzumab, when combined with trastuzumab and chemotherapy, is approved for the pre-surgical (neoadjuvant) treatment of patients with HER2-positive, locally advanced, inflammatory, or early-stage breast cancer. The combination has shown to significantly increase the percentage of patients achieving total pathological complete response[4].

2. Metastatic Breast Cancer: For patients with HER2-positive metastatic breast cancer, Pertuzumab is approved to be used in combination with trastuzumab and docetaxel. Clinical trials have demonstrated that this combination prolongs patient survival[5].

Administration and Dosing:

Pertuzumab is given intravenously. Typically, it's administered every three weeks. The first dose is usually a loading dose, which takes about 60 minutes, while subsequent infusions might take around 30 to 60 minutes[6]. Dosage and treatment frequency might vary based on a patient's medical condition and response to therapy.

perjeta pertuzumab for breast cancer another targeted therapy option

Side Effects and Considerations:

Like all medications, Pertuzumab comes with potential side effects. The most common ones include diarrhea, hair loss, low white blood cell counts, nausea, fatigue, rash, and peripheral neuropathy[7].

However, there are some severe side effects as well:

- Heart problems: Pertuzumab can affect the heart's function, leading to symptoms like shortness of breath, a chronic cough, swelling of the ankles or legs, palpitations, and weight gain of more than five pounds in 24 hours due to fluid retention[7].

- Infusion reactions: Some patients might experience chills, fever, fatigue, headache, dizziness, or breathing difficulties during the infusion[7].

Regular monitoring, including heart function tests, might be required during treatment. It's essential for patients to discuss potential side effects and necessary precautions with their oncologist.

Conclusion:

The advent of targeted therapies like Perjeta (Pertuzumab) has undoubtedly added a new dimension to breast cancer treatment, offering hope to many who battle this aggressive disease. As with all therapies, a thorough understanding of the drug, its benefits, side effects, and optimal usage is pivotal. Pertuzumab represents not just a drug but a testament to the progress being made in oncology, constantly pushing the boundaries to improve patient outcomes.

Bibliography:

[1]: World Health Organization. (2021). *Breast cancer: prevention and control.*

[2]: National Cancer Institute. (2021). *Targeted Cancer Therapies.* (https://www.cancer.gov/about-cancer/treatment/types/targeted-therapies/targeted-therapies-fact-sheet).

[3]: Slamon, D. J., Clark, G. M., Wong, S. G., Levin, W. J., Ullrich, A., & McGuire, W. L. (1987). Human breast cancer: correlation of relapse and survival with amplification of the HER-2/neu oncogene. *Science*, 235(4785), 177-182. (https://science.sciencemag.org/content/235/4785/177.abstract).

[4]: Schneeweiss, A., Chia, S., Hickish, T., Harvey, V., Eniu, A., Hegg, R., Tausch, C., Seo, J.H., Tsai, Y.F., & Ratnayake, J. (2013). Pertuzumab plus trastuzumab in combination with standard neoadjuvant anthracycline-containing and anthracycline-free chemotherapy regimens in patients with HER2-positive early breast cancer: a randomized phase II cardiac safety study (TRYPHAENA). *Annals of Oncology*, 24(9), 2278-2284. (https://academic.oup.com/annonc/article/24/9/2278/195579).

[5]: Swain, S.M., Baselga, J., Kim, S.B., Ro, J., Semiglazov, V., Campone, M., Ciruelos, E., Ferrero, J.M., Schneeweiss, A., & Heeson, S. (2015). Pertuzumab, trastuzumab, and docetaxel in HER2-positive metastatic breast cancer. *The New England Journal of Medicine*, 372(8), 724-734. (https://www.nejm.org/doi/full/10.1056/NEJMoa1413513).

[6]: Genentech, Inc. (2021). *Perjeta (Pertuzumab) Injection.*

[7]: Baselga, J., Cortés, J., Kim, S.B., Im, S.A., Hegg, R., Im, Y.H., Roman, L., Pedrini, J.L., Pienkowski, T., & Knott, A. (2012). Pertuzumab plus trastuzumab plus docetaxel for metastatic breast cancer. *The New England Journal of Medicine*, 366(2), 109-119. [Link](https://www.nejm.org/doi/full/10.1056/NEJMoa1113216).