Adverse reactions and management of Pertuzumab

The most common side effects of Pertuzumab (Pertuzumab) when used with trastuzumab and chemotherapy are neutropenia, diarrhea, nausea, vomiting, alopecia, and fatigue. Among the potential side effects of treatment, cardiac dysfunction is a side effect with potentially serious consequences. In the APHINITY trial, 42 primary cardiac events occurred in 17 patients (0.7%) in the pertuzumab group and 8 patients (0.3%) in the placebo group.

In these studies, cardiac dysfunction resolved after the study was stopped and patients received medications to relieve symptoms. In in vitro studies, ranolazine, a drug used clinically to treat chronic angina and ischemia, not only mitigated the cardiotoxic side effects of trastuzumab, but also mitigated the cardiotoxic side effects of pertuzumab when used in combination therapy in cardiac cell lines. These drugs could rescue patients with HER2-positive breast cancer from treatment-induced heart dysfunction. To prevent severe iatrogenic heart failure, patients are advised to monitor cardiac function regularly.

Pertuzumab is a strictly controlled drug. The original drug has been marketed in China and has entered the ranks of medical insurance, but it is only reimbursed for patients who meet the indications. The price of each box may be more than more than 5,000 yuan, and the price of the Hong Kong version may be more than 20,000 yuan (the price may fluctuate due to exchange rates). The price of each box of the European version of Pertuzumab's original drug marketed overseas may be more than 10,000 yuan, and the price of each box of the Turkish version may be more than 6,000 yuan (the price may fluctuate due to exchange rates). The ingredients of the domestic and foreign original drugs are basically the same, and there are currently no generic versions of Pertuzumab on the market.