# Pertuzumab

Source: https://onco.cc/drugs/pertuzumab/  
OnCo record `pertuzumab` (Treatment). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

A second HER2 antibody that binds a different spot from trastuzumab, blocking HER2 from pairing with HER3; together they extended survival by 16 months in CLEOPATRA.

## Summary

Binds HER2 extracellular domain II, preventing HER2-HER3 heterodimerisation. Approved with trastuzumab and docetaxel in first-line metastatic disease (2012), neoadjuvant (2013, first pCR-based accelerated approval), and adjuvant node-positive disease (2017, APHINITY). Phesgo (2020) delivers both antibodies subcutaneously in minutes. Being partnered with T-DXd in first line (DESTINY-Breast09) and tucatinib in maintenance (HER2CLIMB-05).

## Fields

- Kind: Treatment
- Status: approved
- Last checked: 2026-09-07
- Brand: Perjeta; Phesgo (with trastuzumab, subcutaneous)
- Modality: Monoclonal antibody (anti-HER2, dimerisation domain)
- Mechanism: Anti-HER2 IgG1 against subdomain II; blocks ligand-dependent HER2-HER3 signalling; ADCC.
- Approvals: US 2012: First-line HER2+ metastatic breast cancer with trastuzumab and docetaxel; US 2013: Neoadjuvant HER2+ early breast cancer (accelerated; first pCR-based approval); US 2017: Adjuvant HER2+ early breast cancer at high risk of recurrence; US 2020: Phesgo subcutaneous fixed-dose combination with trastuzumab
- Dosing: Intravenous (or subcutaneous as Phesgo); 840 mg loading then 420 mg every 3 weeks; Phesgo 1200/600 mg loading then 600/600 mg SC every 3 weeks
- Toxicity (grade 3+): Diarrhoea 8%; Left ventricular dysfunction 1.2%; Febrile neutropenia (with docetaxel) 14%

## Notes

- Biliary tract cancer: with trastuzumab in the MyPathway basket, 9 of 39 patients with HER2-amplified or overexpressing metastatic biliary tract cancer responded (23 percent, 95 percent confidence interval 11 to 39); the UK DETERMINE platform (Cancer Research UK) offers the same pair to HER2-amplified rare cancers including gallbladder cancer at 27 NHS sites.
- Colorectal cancer biomarkers: TRIUMPH enrolled on HER2 amplification confirmed in tissue or in circulating tumour DNA and gave confirmed responses in 30% of 27 tissue-positive and 28% of 25 ctDNA-positive patients, against 0% in a matched real-world salvage population; concurrent oncogenic RAS alterations in plasma predicted poor response (Nakamura 2021).

## Sources

- Wikipedia: https://en.wikipedia.org/wiki/Pertuzumab
- FDA label (DailyMed): https://dailymed.nlm.nih.gov/dailymed/search.cfm?query=Pertuzumab

## Connected records

- biomarkers: [HER2 IHC 3+ (HER2-positive by immunohistochemistry)](https://onco.cc/biomarkers/her2-ihc-3-plus/), [HER2 ISH amplified (ERBB2 gene amplification)](https://onco.cc/biomarkers/her2-ish-amplified/)
- cancers: [Biliary tract cancer (all types)](https://onco.cc/cancers/biliary-tract-cancer/), [Biliary tract cancer (cholangiocarcinoma)](https://onco.cc/cancers/cholangiocarcinoma/), [Colorectal cancer](https://onco.cc/cancers/colorectal/), [Early HER2-positive breast cancer](https://onco.cc/cancers/her2-positive-early-breast-cancer/), [Gallbladder cancer](https://onco.cc/cancers/gallbladder/), [HER2-amplified colorectal cancer](https://onco.cc/cancers/her2-amplified-colorectal/), [HER2-positive breast cancer](https://onco.cc/cancers/breast-her2-positive/), [HER2-positive breast cancer with brain metastases](https://onco.cc/cancers/her2-positive-breast-brain-metastases/), [Inflammatory breast cancer](https://onco.cc/cancers/inflammatory-breast-cancer/)
- technologies: [Monoclonal antibodies](https://onco.cc/technologies/monoclonal-antibody/)
- targets: [HER2](https://onco.cc/targets/her2/), [HER3](https://onco.cc/targets/her3/)
- companies: [Roche / Genentech](https://onco.cc/companies/roche-genentech/)
- trials: [A Phase 1 Trial of ZN-A-1041 Enteric Capsules or Combination in Participants With Human Epidermal Growth Factor Receptor 2 (HER2)-Positive Advanced So](https://onco.cc/trials/nct05593094/), [A Phase 1/2a Study of DB-1303/BNT323 in Advanced/Metastatic Solid Tumors](https://onco.cc/trials/nct05150691/), [A Phase 1b/2 Study of T-DXd Combinations in HER2-positive Metastatic Breast Cancer](https://onco.cc/trials/nct04538742/), [A Phase 2 Neoadjuvant Study of Zanidatamab in Combination With Chemotherapy in Participants With HER2-positive Breast Cancer](https://onco.cc/trials/nct07102381/), [A Phase III Study of SHR-A1811 Injection With or Without Pertuzumab in HER2-Positive Recurrent or Metastatic Breast Cancer](https://onco.cc/trials/nct06057610/), [A Safety and Efficacy Extension Study of Pertuzumab in Patients With Solid Tumors Previously Enrolled in a Hoffmann-La Roche-Sponsored Pertuzumab Clinical Trial](https://onco.cc/trials/nct02320435/), [A Safety Extension Study of Trastuzumab Emtansine in Participants Previously Treated With Trastuzumab Emtansine Alone or in Combination With Other Anti-Cancer Therapy in One of the Parent Studies](https://onco.cc/trials/nct00781612/), [A Study of BL-M07D1 Combined With Pertuzumab Versus Docetaxel Plus Trastuzumab and Pertuzumab in Patients With First-line HER2-positive Recurrent or M](https://onco.cc/trials/nct07518173/), [A Study of BL-M07D1 With or Without Pertuzumab Versus Docetaxel + Carboplatin + Trastuzumab + Pertuzumab in Neoadjuvant Therapy for HER2-Positive Brea](https://onco.cc/trials/nct06891833/), [A Study of BL-M07D1, BL-M07D1+Pertuzumab and BL-M07D1+Pertuzumab+Docetaxel in Patients With Unresectable Locally Advanced or Metastatic HER2-positive ](https://onco.cc/trials/nct06445400/), [A Study of HRS-4508 in Combination With Other Anti-tumor Therapy for Solid Tumor](https://onco.cc/trials/nct07140393/), [A Study to Evaluate HLX22 in Combination With HLX87 in Patients With HER2-Positive Recurrent or Metastatic Breast Cancer](https://onco.cc/trials/nct07294508/), [A Trial of SHR-A1811 Compared to Other Antitumor Therapies as Neoadjuvant Treatments in Early-stage or Locally Advanced HER2-positive Breast Cancer](https://onco.cc/trials/nct07196774/), [APHINITY](https://onco.cc/trials/aphinity/), [CLEOPATRA](https://onco.cc/trials/cleopatra/), [Clinical Study of the Efficacy and Safety of BCD-178 and Perjeta® as Neoadjuvant Therapy of HER2-Positive Breast Cancer](https://onco.cc/trials/nct05802225/), [CUPISCO](https://onco.cc/trials/cupisco/), [DESTINY-Breast09](https://onco.cc/trials/destiny-breast09/), [DETERMINE](https://onco.cc/trials/determine-trial/), [DETERMINE arm 04: trastuzumab with pertuzumab in HER2-amplified or mutated rare cancers](https://onco.cc/trials/determine-arm04/), [Docetaxel, Carboplatin, Trastuzumab, and Pertuzumab With or Without Estrogen Deprivation in Treating Patients With Hormone Receptor-Positive, HER2-Positive Operable or Locally Advanced Breast Cancer](https://onco.cc/trials/nct02003209/), [DV in Combination With Pertuzumab With or Without Toripalimab Neoadjuvant Therapy With HER2-positive Breast Cancer](https://onco.cc/trials/nct06178159/), [HER2CLIMB-05](https://onco.cc/trials/her2climb-05/), [HERACLES](https://onco.cc/trials/heracles/), [I-SPY 2](https://onco.cc/trials/i-spy-2/), [Identification and Treatment Of Micrometastatic Disease in Stage III Colon Cancer](https://onco.cc/trials/nct03803553/), [KRISTINE](https://onco.cc/trials/kristine/), [MARGetuximab Or Trastuzumab (MARGOT)](https://onco.cc/trials/nct04425018/), [MyPathway](https://onco.cc/trials/mypathway/), [NeoSphere](https://onco.cc/trials/neosphere/), [Optimization of Dynamic Neoadjuvant Therapy Strategies for HER2-Positive Breast Cancer Based on HER2-PET/CT Molecular Imaging](https://onco.cc/trials/nct07527806/), [PATINA](https://onco.cc/trials/patina/), [PHERGain](https://onco.cc/trials/phergain/), [Safety and Efficacy of HCB101 in Combination With Multiple Agents in Patients With Advanced Solid Tumors](https://onco.cc/trials/nct06771622/), [Study of Alpelisib (BYL719) in Combination With Trastuzumab and Pertuzumab as Maintenance Therapy in Patients With HER2-positive Advanced Breast Cancer With a PIK3CA Mutation](https://onco.cc/trials/nct04208178/), [Study of Patritumab Deruxtecan With Other Anticancer Agents in Participants With HER2 Positive Breast Cancer That Has Spread and Cannot Be Surgically Removed (MK-1022-009)](https://onco.cc/trials/nct06686394/), [TAPUR (Targeted Agent and Profiling Utilization Registry)](https://onco.cc/trials/tapur/), [The Sagittarius Trial](https://onco.cc/trials/nct06490536/), [TRAIN-2](https://onco.cc/trials/train-2/), [Trastuzumab Rezetecan Combined With Pertuzumab and Iparomlimab and Tuvonralimab for Biliary Tract Cancer](https://onco.cc/trials/nct07129018/), [Treatment of Breast Cancer With Trastuzumab + HS627/ Pertuzumab + Docetaxel](https://onco.cc/trials/nct04514419/), [TRIUMPH](https://onco.cc/trials/triumph/)
- key papers: [APHINITY: adjuvant pertuzumab added to trastuzumab and chemotherapy in early HER2-positive breast cancer](https://onco.cc/key-papers/paper-aphinity-nejm-2017/), [Circulating tumor DNA-guided treatment with pertuzumab plus trastuzumab for HER2-amplified metastatic colorectal cancer: a phase 2 trial (TRIUMPH)](https://onco.cc/key-papers/paper-nakamura-triumph-ctdna-pertuzumab-trastuzumab-her2-colorectal-nat-med-2021/), [Pertuzumab and trastuzumab for HER2-positive, metastatic biliary tract cancer (MyPathway): a multicentre, open-label, phase 2a, multiple basket study](https://onco.cc/key-papers/paper-javle-mypathway-her2-biliary-lancet-oncol-2021/)
- terms: [Dual HER2 blockade](https://onco.cc/terms/dual-her2-blockade/), [HER2-positive (IHC 3+ or ISH-amplified)](https://onco.cc/terms/her2-positive/), [Trastuzumab cardiotoxicity](https://onco.cc/terms/trastuzumab-cardiotoxicity/)
- pairings: [Early FDG-PET response → chemotherapy omission (HER2+)](https://onco.cc/pairings/pet-adapted-her2-deescalation/)
- ideas: [Can T-DXd alone cure early HER2-positive disease?](https://onco.cc/ideas/idea-tdxd-first-then-nothing/)
- people: [Javier Cortés](https://onco.cc/people/javier-cortes/)
- institutions: [Georgetown Lombardi Comprehensive Cancer Center](https://onco.cc/institutions/georgetown-lombardi/)
- pathways: [Breast cancer (KEGG map)](https://onco.cc/pathways/breast-cancer-signalling/), [Receptor tyrosine kinase activation](https://onco.cc/pathways/rtk-activation/)

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