- The initial dose is 840 mg administered as a 60 min IV infusion, followed every 3 wks thereafter by a dose of 420 mg administered over 30-60 minutes as an IV infusion.
- Must be used in a combination with trastuzumab and docetaxel
- Trastuzumab: The recommended initial dose is 8 mg/kg IV administered as a 90 min IV infusion, followed every 3 wks thereafter by a dose of 6 mg/kg administered over 30-90 mins as an IV infusion.
- Docetaxel: The recommended initial dose is 75 mg/m2 IV. May increase to 100 mg/m2 every 3 wks if initial dose is well tolerated
- Pertuzumab, trastuzumab, and docetaxel should be administered subsequently. Pertuzumab and trastuzumab can be given in any order, but docetaxel should be administered after pertuzumab and trastuzumab
- 30 to 60 minutes of observation period is recommended after each pertuzumab infusion and before starting of any subsequent infusion of trastuzumab or docetaxel
- Dose modification
- Delayed or missed dose: time between 2 doses <6 wks, the 420 mg dose of pertuzumab should be administered. Time between 2 doses
6 wks: Initial dose of 840 mg IV infusion over 60 mins should be administered, followed every 3wks thereafter by a 420 mg IV infusion over 30-60 minutes. - Decrease or interrupt the infusion rate if infusion associated reaction occurs, and discontinue if severe hypersensitivity reaction occurs
- Left Ventricular Ejection Fraction (LVEF): Withhold pertuzumab and trastuzumab dosing for at least 3 wks if LVEF < 40% or 40-45% with 10% or greater absolute decrease below pretreatment values below baseline. Discontinue pertuzumab and trastuzumab if LVEF has worsened or not improved within 3 wks
- Withhold or discontinue pertuzumab if trastuzumab is withheld or discontinued; may continue therapy with pertuzumab and trastuzumab if docetaxel has been discontinued
- Pertuzumab dose reductions are not recommended
- Safety and effectiveness in patients <18 yrs have not been established
