Difference between revisions of "Pertuzumab (Perjeta)"

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'''FDA approved 6/8/2012.''' 
 
 
 
==General information==
 
==General information==
Class/mechanism: Humanized monoclonal antibody that binds to the extracellular dimerization subdomain II of HER2, preventing dimerization with other HER receptors (i.e. EGFR/HER1, HER3, and HER4).  Pertuzumab inhibits ligand-initiated intracellular signaling via the MAP (mitogen-activated protein) kinase and PI3K (phosphoinositide 3-kinase) pathways, which results in cell growth arrest and apoptosis. Also stimulates antibody-dependent cell-mediated cytotoxicity (ADCC).<ref name="insert">[http://www.gene.com/gene/products/information/perjeta/pdf/perjeta_prescribing.pdf Pertuzumab (Perjeta) package insert]</ref><ref>[[Media:Pertuzumab.pdf | Pertuzumab (Perjeta) package insert (locally hosted backup)]]</ref><ref>[http://www.perjeta.com/ Perjeta manufacturer's website]</ref>
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Class/mechanism: Humanized monoclonal antibody that binds to the extracellular dimerization subdomain II of HER2, preventing dimerization with other HER receptors (i.e. EGFR/HER1, HER3, and HER4).  Pertuzumab inhibits ligand-initiated intracellular signaling via the MAP (mitogen-activated protein) kinase and PI3K (phosphoinositide 3-kinase) pathways, which results in cell growth arrest and apoptosis. Also stimulates antibody-dependent cell-mediated cytotoxicity (ADCC).<ref name="insert">[https://www.gene.com/download/pdf/perjeta_prescribing.pdf Pertuzumab (Perjeta) package insert]</ref><ref>[[:File:Pertuzumab.pdf | Pertuzumab (Perjeta) package insert (locally hosted backup)]]</ref><ref>[http://www.perjeta.com/ Perjeta manufacturer's website]</ref>
 
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<br>Route: IV
Route: IV
 
 
<br>Extravasation: no information
 
<br>Extravasation: no information
  
For conciseness and simplicity, HemOnc.org currently will focus on treatment regimens and not list information such as: renal/hepatic dose adjustments, metabolism (including CYP450), excretion, monitoring parameters (although this will be considered for checklists), or manufacturer. Instead, for the most current information, please refer to your preferred pharmacopeias such as [http://www.thomsonhc.com/home/dispatch Micromedex], [http://online.lexi.com/ Lexicomp], [http://www.utdol.com/online/content/search.do UpToDate (courtesy of Lexicomp)], or the package insert.<ref name="insert"></ref>
+
For conciseness and simplicity, HemOnc.org currently will focus on treatment regimens and not list information such as: renal/hepatic dose adjustments, metabolism (including CYP450), excretion, monitoring parameters (although this will be considered for checklists), or manufacturer. Instead, for the most current information, please refer to your preferred pharmacopeias such as [http://www.thomsonhc.com/home/dispatch Micromedex], [http://online.lexi.com/ Lexicomp], [http://www.utdol.com/online/content/search.do UpToDate (courtesy of Lexicomp)], or the package insert.<ref name="insert"></ref>
 +
==Diseases for which it is established==
 +
*[[Breast_cancer,_HER2-positive|HER2+ breast cancer]]
 +
*[[Colorectal cancer, HER2-positive|HER2+ colon cancer]]
  
 
==Diseases for which it is used==
 
==Diseases for which it is used==
*[[Breast cancer]]
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*[[Malignant solid neoplasm, ERBB2-mutated|HER2+ tumors (site-agnostic)]]
 
 
==Clinical trials==
 
*[http://www.nejm.org/doi/full/10.1056/NEJMoa1113216 CLEOPATRA trial]<ref>Baselga J, Cortés J, Kim SB, Im SA, Hegg R, Im YH, Roman L, Pedrini JL, Pienkowski T, Knott A, Clark E, Benyunes MC, Ross G, Swain SM; CLEOPATRA Study Group. Pertuzumab plus trastuzumab plus docetaxel for metastatic breast cancer. N Engl J Med. 2012 Jan 12;366(2):109-19. Epub 2011 Dec 7. [http://www.nejm.org/doi/full/10.1056/NEJMoa1113216 link to original article] [http://www.ncbi.nlm.nih.gov/pubmed/22149875 PubMed]</ref>
 
*[http://www.sciencedirect.com/science/article/pii/S1470204511703369 NeoSphere trial]<ref>Gianni L, Pienkowski T, Im YH, Roman L, Tseng LM, Liu MC, Lluch A, Staroslawska E, de la Haba-Rodriguez J, Im SA, Pedrini JL, Poirier B, Morandi P, Semiglazov V, Srimuninnimit V, Bianchi G, Szado T, Ratnayake J, Ross G, Valagussa P. Efficacy and safety of neoadjuvant pertuzumab and trastuzumab in women with locally advanced, inflammatory, or early HER2-positive breast cancer (NeoSphere): a randomised multicentre, open-label, phase 2 trial. Lancet Oncol. 2012 Jan;13(1):25-32. Epub 2011 Dec 6. [http://www.sciencedirect.com/science/article/pii/S1470204511703369 link to original article] [http://www.ncbi.nlm.nih.gov/pubmed/22153890 PubMed]</ref>
 
  
 
==Patient drug information==
 
==Patient drug information==
*[http://chemocare.com/chemotherapy/drug-info/Pertuzumab.aspx Pertuzumab (Perjeta) patient drug information (Chemocare)]<ref>[http://chemocare.com/chemotherapy/drug-info/Pertuzumab.aspx Pertuzumab (Perjeta) patient drug information (Chemocare)]</ref>
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*[https://www.gene.com/download/pdf/perjeta_prescribing.pdf Pertuzumab (Perjeta) package insert]<ref name="insert"></ref>
*[http://www.perjeta.com/patient/index Pertuzumab (Perjeta) patient drug information]<ref>[http://www.perjeta.com/patient/index Pertuzumab (Perjeta) patient drug information]</ref>
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*[https://chemocare.com/druginfo/Pertuzumab.aspx Pertuzumab (Perjeta) patient drug information (Chemocare)]<ref>[https://chemocare.com/druginfo/Pertuzumab.aspx Pertuzumab (Perjeta) patient drug information (Chemocare)]</ref>
*Brief patient counseling information can be found on [http://www.gene.com/gene/products/information/perjeta/pdf/perjeta_prescribing.pdf#page=16 page 16 of the package insert]<ref name="insert"></ref>
 
 
*[http://www.uptodate.com/contents/pertuzumab-patient-drug-information Pertuzumab (Perjeta) patient drug information (UpToDate)]<ref>[http://www.uptodate.com/contents/pertuzumab-patient-drug-information Pertuzumab (Perjeta) patient drug information (UpToDate)]</ref>
 
*[http://www.uptodate.com/contents/pertuzumab-patient-drug-information Pertuzumab (Perjeta) patient drug information (UpToDate)]<ref>[http://www.uptodate.com/contents/pertuzumab-patient-drug-information Pertuzumab (Perjeta) patient drug information (UpToDate)]</ref>
  
 
==History of changes in FDA indication==
 
==History of changes in FDA indication==
*6/8/2012: [http://www.fda.gov/Drugs/InformationOnDrugs/ApprovedDrugs/ucm307592.htm FDA approved] "for use in combination with trastuzumab and docetaxel for the treatment of patients with HER2-positive metastatic breast cancer who have not received prior anti-HER2 therapy or chemotherapy for metastatic disease."
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*2012-06-08: [http://www.fda.gov/Drugs/InformationOnDrugs/ApprovedDrugs/ucm307592.htm FDA approved] for use in combination with [[Trastuzumab (Herceptin)|trastuzumab]] and [[Docetaxel (Taxotere)|docetaxel]] for the treatment of patients with [[Biomarkers#HER2|HER2]]-[[Biomarkers#Overexpression|positive]] metastatic [[breast cancer]] who have '''not received''' prior anti-HER2 therapy or chemotherapy for metastatic disease. ''(Based on CLEOPATRA)''
 +
*2013-09-30: Granted accelerated approval for use in combination with [[Trastuzumab (Herceptin)|trastuzumab]] and [[Docetaxel (Taxotere)|docetaxel]] for the neoadjuvant treatment of patients with [[Biomarkers#HER2|HER2]]-[[Biomarkers#Overexpression|positive]], locally advanced, inflammatory, or early stage [[breast cancer]] (either greater than 2 cm in diameter or node positive) as part of a complete treatment regimen for early breast cancer. ''(Approval extended to the neoadjuvant setting; based on NeoSphere, TRYPHAENA, BERENICE)''
 +
**2017-12-20: [https://www.fda.gov/drugs/resources-information-approved-drugs/fda-grants-regular-approval-pertuzumab-adjuvant-treatment-her2-positive-breast-cancer Regular FDA approval] for use in combination with [[Trastuzumab (Herceptin)|trastuzumab]] and chemotherapy as adjuvant treatment of patients with [[Biomarkers#HER2|HER2]]-[[Biomarkers#Overexpression|positive]] early [[breast cancer]] at high risk of recurrence. ''(Granted regular approval; Approval extended to the adjuvant setting; based on APHINITY)''
 +
 
 +
==History of changes in EMA indication==
 +
*2013-03-04: Initial marketing authorization as Perjeta. Perjeta is indicated for use in combination with trastuzumab and docetaxel in adult patients with HER2-positive metastatic or locally recurrent unresectable [[breast cancer]], who have not received previous anti-HER2 therapy or chemotherapy for their metastatic disease. ''(Based on CLEOPATRA)''
 +
*2015-07-28: Extension of indication to include the use of pertuzumab in combination with trastuzumab and chemotherapy for the neoadjuvant treatment of adult patients with HER2-positive, locally advanced, inflammatory, or early stage [[breast cancer]] at high risk of recurrence.
 +
*2018-05-31: Extension of indication for Perjeta, in combination with trastuzumab and chemotherapy, for the adjuvant treatment of adult patients with HER2-positive early [[breast cancer]] at high risk of recurrence. ''(Based on APHINITY)''
 +
==History of changes in Health Canada indication==
 +
*2012-08-31: Initial notice of compliance for the treatment of patients with HER2-positive metastatic [[breast cancer]] who have not received prior anti-HER2 therapy or chemotherapy for metastatic disease.
 +
==History of changes in PMDA indication==
 +
*2013-06-28: Initial approval for the treatment of unresectable or recurrent HER2-positive [[breast cancer]].
 +
*2018-10-10: New indication for the treatment of HER2-positive [[breast cancer]].
 +
*2022-03-28: New indication and a new dosage for the treatment of unresectable advanced or recurrent HER2-positive [[Colorectal cancer|colon or rectal cancer]] that has progressed after cancer chemotherapy.
  
 
==Also known as==
 
==Also known as==
2C4, Omnitarg, Rhumab 2C4.
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*'''Code names:''' 2C4, Rhumab 2C4.
 +
*'''Brand names:''' Omnitarg, Perjeta
  
 
==References==
 
==References==
 
<references/>
 
<references/>
  
[[Category:Drug index]]
+
[[Category:Drugs]]
[[Category:Chemotherapy]]
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[[Category:Intravenous medications]]
[[Category:Intravenous chemotherapy]]
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[[Category:Protein expression-specific medications]]
 +
 
 +
[[Category:Anti-HER2 antibodies]]
  
[[Category:Antibody medications]]
 
[[Category:Anti-HER2 medications]]
 
 
[[Category:Breast cancer medications]]
 
[[Category:Breast cancer medications]]
[[Category:Drugs FDA approved in 2012]]
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[[Category:Colorectal cancer medications]]
 +
[[Category:Malignant solid neoplasm, ERBB2-mutated medications]]
 +
 
 +
[[Category:EMA approved in 2013]]
 +
[[Category:FDA approved in 2012]]
 +
[[Category:Health Canada approved in 2012]]
 +
[[Category:PMDA approved in 2013]]

Latest revision as of 21:15, 21 September 2023

General information

Class/mechanism: Humanized monoclonal antibody that binds to the extracellular dimerization subdomain II of HER2, preventing dimerization with other HER receptors (i.e. EGFR/HER1, HER3, and HER4). Pertuzumab inhibits ligand-initiated intracellular signaling via the MAP (mitogen-activated protein) kinase and PI3K (phosphoinositide 3-kinase) pathways, which results in cell growth arrest and apoptosis. Also stimulates antibody-dependent cell-mediated cytotoxicity (ADCC).[1][2][3]
Route: IV
Extravasation: no information

For conciseness and simplicity, HemOnc.org currently will focus on treatment regimens and not list information such as: renal/hepatic dose adjustments, metabolism (including CYP450), excretion, monitoring parameters (although this will be considered for checklists), or manufacturer. Instead, for the most current information, please refer to your preferred pharmacopeias such as Micromedex, Lexicomp, UpToDate (courtesy of Lexicomp), or the package insert.[1]

Diseases for which it is established

Diseases for which it is used

Patient drug information

History of changes in FDA indication

  • 2012-06-08: FDA approved for use in combination with trastuzumab and docetaxel for the treatment of patients with HER2-positive metastatic breast cancer who have not received prior anti-HER2 therapy or chemotherapy for metastatic disease. (Based on CLEOPATRA)
  • 2013-09-30: Granted accelerated approval for use in combination with trastuzumab and docetaxel for the neoadjuvant treatment of patients with HER2-positive, locally advanced, inflammatory, or early stage breast cancer (either greater than 2 cm in diameter or node positive) as part of a complete treatment regimen for early breast cancer. (Approval extended to the neoadjuvant setting; based on NeoSphere, TRYPHAENA, BERENICE)

History of changes in EMA indication

  • 2013-03-04: Initial marketing authorization as Perjeta. Perjeta is indicated for use in combination with trastuzumab and docetaxel in adult patients with HER2-positive metastatic or locally recurrent unresectable breast cancer, who have not received previous anti-HER2 therapy or chemotherapy for their metastatic disease. (Based on CLEOPATRA)
  • 2015-07-28: Extension of indication to include the use of pertuzumab in combination with trastuzumab and chemotherapy for the neoadjuvant treatment of adult patients with HER2-positive, locally advanced, inflammatory, or early stage breast cancer at high risk of recurrence.
  • 2018-05-31: Extension of indication for Perjeta, in combination with trastuzumab and chemotherapy, for the adjuvant treatment of adult patients with HER2-positive early breast cancer at high risk of recurrence. (Based on APHINITY)

History of changes in Health Canada indication

  • 2012-08-31: Initial notice of compliance for the treatment of patients with HER2-positive metastatic breast cancer who have not received prior anti-HER2 therapy or chemotherapy for metastatic disease.

History of changes in PMDA indication

  • 2013-06-28: Initial approval for the treatment of unresectable or recurrent HER2-positive breast cancer.
  • 2018-10-10: New indication for the treatment of HER2-positive breast cancer.
  • 2022-03-28: New indication and a new dosage for the treatment of unresectable advanced or recurrent HER2-positive colon or rectal cancer that has progressed after cancer chemotherapy.

Also known as

  • Code names: 2C4, Rhumab 2C4.
  • Brand names: Omnitarg, Perjeta

References