Debu Tripathy, MD, professor and chairman, Department of Breast Medical Oncology, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, discusses the use of pertuzumab in HER2-positive breast cancer.
Debu Tripathy, MD, professor and chairman, Department of Breast Medical Oncology, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, discusses the use of pertuzumab (Perjeta) in the treatment of patients with HER2-positive breast cancer.
Most active in the metastatic setting, pertuzumab has its most notable impact when used in combination with the other HER2-targeted agent trastuzumab (Herceptin). Pertuzumab was first approved by the FDA for use in the early-stage setting, but Tripathy says patients are also able to achieve pathologic complete responses when given this drug in the neoadjuvant setting.
Importantly, researchers are looking for a more aggressive approach in the adjuvant setting to prevent recurrences in this patient population. Results from the APHINITY trial demonstrated that the addition of pertuzumab to standard adjuvant therapy reduced the risk of recurrence and improved survival. Although the absolute benefit of pertuzumab was small, Tripathy says this was likely due to the broad patient population included in the trial. In terms of safety, the drug was found to be well tolerated. Although there were some added gastrointestinal toxicities observed, it does not seem to increase cardiac toxicity. However, Tripathy concludes that as pertuzumab becomes more prevalent in treatment, the cost of the agent is an issue that will need to be addressed.