What are the precautions for taking Pertuzumab?

During treatment with Pertuzumab (Pertuzumab), patients need to pay attention to the occurrence of left ventricular dysfunction, infusion-related reactions, allergic reactions, embryo-fetal toxicity and other events. If they feel unwell, they should inform their doctor in time.

1. Left ventricular dysfunction (LVEF):

Pertuzumab can cause subclinical and clinical heart failure, manifested bydecreased LVEF and congestive heart failure. Drugs that block HER2 activity, including pertuzumab, have been reported to reduce LVEF. Assess LVEF before starting pertuzumab and periodically during treatment to ensure that LVEF is within the normal range. If LVEF declines without improvement or declines further on subsequent evaluation, discontinuation of pertuzumab and trastuzumab should be strongly considered.

2. Infusion-related reactions:

In clinical studies in which initial doses of pertuzumab were administered the day before trastuzumab and docetaxel, the most common infusion reactions (≥1.0%) were pyrexia, chills, fatigue, headache, asthenia, anaphylaxis, and vomiting. Observe patients closely for 60 minutes after the first infusion and for 30 minutes after subsequent pertuzumab infusions. If significant infusion-related reactions occur, slow or interrupt the infusion and administer appropriate medical treatment. Monitor patients carefully until symptoms and signs completely resolve. Consider permanent discontinuation of the drug in patients who experience severe infusion reactions.

3. Allergic reaction:

Patients should be closely observed for allergic reactions. Serious allergic reactions, including anaphylaxis and fatal events, have been observed in patients treated with pertuzumab. Angioedema has been described in postmarketing reports, and medications to treat such reactions, as well as first aid equipment, should be immediately available. This product is contraindicated in patients with known hypersensitivity to pertuzumab or any of its excipients.

4. Embryo-Fetotoxicity:

Based on its mechanism of action and animal studies, pertuzumab can cause fetal harm when administered to pregnant women. Oligohydramnios and oligohydramnios sequences have been reported with use of another HER2/neu receptor antagonist (trastuzumab) during pregnancy, manifesting as pulmonary hypoplasia, skeletal abnormalities, and neonatal death. Advise females of reproductive potential to use an effective method of contraception during treatment and for 7 months after the last dose of pertuzumab in combination with trastuzumab.

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.