Understanding HER2+ early breast cancer (eBC) treatment 

Based on your answers, your doctor may recommend different treatment options.

One or more of these is true:

  • I am seeking information about HER2-positive early breast cancer
Clear and start over

Quick Links

Prepare for a conversation with your doctor
Diagnosis
Neoadjuvant treatment
Surgery
Adjuvant treatment
Cancer support organizations

Prepare for a conversation with your doctor

Below are some starter questions to begin a conversation with your doctor or care team:

  • What is HER2+ eBC?
  • Can we discuss my treatment goals?
  • Will treatment be given before or after surgery, or both?
  • What is the difference between the HER2+ early breast cancer therapies?
  • What can I expect during treatment?
  • How will you know if my treatment is working?
  • Will I also receive chemotherapy?
  • What kind of side effects might I experience?
Back to Top

Diagnosis

After confirming your diagnosis, your doctor will review factors such as HER2 status, nodal status, tumor size, patient characteristics, and preferences. For HER2-positive early breast cancer (HER2+ eBC), doctors often recommend neoadjuvant treatment. In some cases, doctors may recommend starting with surgery followed by adjuvant treatment.

Back to Top

Neoadjuvant treatment

Before surgery, neoadjuvant treatment is given to shrink the tumor.

Below are two of the HER2-targeted neoadjuvant treatment options available

People with HER2+, locally advanced, inflammatory, or early-stage (tumor is greater than 2 cm in diameter or node positive) breast cancer before surgery.

PERJETA is given with another HER2-targeted treatment called Herceptin® (trastuzumab) and chemotherapy. PERJETA and Herceptin are intravenous (IV) infusions that are given back to back in about 1-2.5 hours.*

*This does not account for observation time and other aspects of treatment. Actual clinic time may vary.

PHESGO combines PERJETA and Herceptin in a single injection just under the skin. It is given with chemotherapy. The first dose of PHESGO takes about 8 minutes. After that, receiving PHESGO takes about 5 minutes.*

*This does not account for observation time and other aspects of treatment. Actual clinic time may vary.

For patients who received PERJETA + Herceptin before surgery, the doctor may be able to switch them to PHESGO after surgery.

What are the most serious side effects of PERJETA and PHESGO?

  • PERJETA and PHESGO may cause heart problems, including those without symptoms (such as reduced heart function) and those with symptoms (such as congestive heart failure).
  • Receiving PERJETA or PHESGO during pregnancy can result in the death of an unborn baby and birth defects.
  • PHESGO may cause serious lung problems.

Please see full Prescribing Information for additional Important Safety Information, including most serious side effects, for PERJETA and PHESGO.

Know what to ask your doctor
Back to Top

Surgery

The goal of surgery is to remove as many cancer cells as possible. A doctor will then carefully examine the tissue removed to determine the next phase of treatment. If cancerous cells are detected, the oncologist will likely recommend an adjuvant treatment to remove the residual disease. If the doctor cannot find any cancer cells remaining, the patient has experienced what is known as a pCR. In such cases, adjuvant treatment may be recommended to lower the chance of the cancer returning. 

Back to Top

Adjuvant Treatment

Adjuvant therapy is treatment given after surgery with the goal of:

  1. Killing remaining cancer calls
  2. Lowering the chance of the cancer returning

A doctor may recommend adjuvant treatment even if the surgery resulted in a pCR to help keep a patient cancer-free for as long as possible.

Recommendations for adjuvant therapy may depend on whether you received neoadjuvant treatment and how you responded to it.

If a patient received neoadjuvant treatment before surgery, then they may continue that treatment regimen or switch to a different adjuvant therapy after surgery.

If a patient did not receive neoadjuvant treatment, then the patient may start adjuvant treatment after surgery.

Back to Top

Below are three of the HER2-targeted adjuvant treatment options available

People with HER2+, locally advanced, inflammatory, or early-stage (tumor is greater than 2 cm in diameter or node positive) breast cancer before surgery.

PERJETA is given with another HER2-targeted treatment called Herceptin® (trastuzumab) and chemotherapy. PERJETA and Herceptin are intravenous (IV) infusions that are given back to back in about 1-2.5 hours.*

*This does not account for observation time and other aspects of treatment. Actual clinic time may vary.

Patients may start this HER2-targeted treatment after surgery or continue treatment if they received PERJETA + Herceptin and chemotherapy before surgery and have a pCR after surgery.

PHESGO combines PERJETA and Herceptin in a single injection just under the skin. It is given with chemotherapy. The first dose of PHESGO takes about 8 minutes. After that, receiving PHESGO takes about 5 minutes.*

*This does not account for observation time and other aspects of treatment. Actual clinic time may vary.

Patients may start this treatment after surgery or continue PHESGO if they received it before surgery, even if they have a pCR after surgery.

For patients who received PERJETA + Herceptin before surgery, the doctor may be able to switch them to PHESGO after surgery.

What are the most serious side effects of PERJETA and PHESGO?

  • PERJETA and PHESGO may cause heart problems, including those without symptoms (such as reduced heart function) and those with symptoms (such as congestive heart failure).
  • Receiving PERJETA or PHESGO during pregnancy can result in the death of an unborn baby and birth defects.
  • PHESGO may cause serious lung problems.

Please see full Prescribing Information for additional Important Safety Information, including most serious side effects, for PERJETA and PHESGO.

Know what to ask your doctor
Back to Top

People with HER2+ early breast cancer who had treatment before surgery (including a taxane and trastuzumab) and there is cancer remaining in the tissue removed during surgery.

KADCYLA is used after surgery and is given as an intravenous (IV) infusion for 30-90 minutes.*

*This does not account for observation time and other aspects of treatment. Actual clinic time may vary.

What are the most serious side effects of KADCYLA?

  • KADCYLA can cause severe liver problems.
  • KADCYLA may cause heart problems, including those without symptoms (such as reduced heart function) and those with symptoms (such as congestive heart failure).
  • Receiving KADCYLA during pregnancy can result in the death of an unborn baby and birth defects.

Please see full Prescribing Information for additional Important Safety Information, including the most serious side effects, for KADCYLA.

Keep in mind that this site is for educational purposes only and that the options here are just some of the treatments you may be eligible for. Your primary sources of information should always be your doctor and the professionals who make up your care team. Only they can give you medical advice about your disease and treatment.

Back to Top

Learn about breast cancer resources and support organizations

As you prepare to discuss your condition with your doctor, here are some resources you may find helpful. Ask your doctor or your care team any questions you have about your cancer or treatment plan.*

American Cancer Society
www.cancer.org

Information for people living with cancer, as well as families, friends, and survivors.

BreastCancer.org
www.breastcancer.org

Medical information about treatment options, symptoms, diagnosis, and prevention.

Living Beyond Breast Cancer
www.lbbc.org

Support and information for people who are newly diagnosed, in treatment, years beyond treatment, or living with breast cancer.

SHARE
www.sharecancersupport.org

A network of breast and other cancer survivors who want to share their experience with others.

Susan G. Komen
www.komen.org

Information for people living with cancer, families, friends, and survivors.

Young Survival Coalition
www.youngsurvival.org

An organization dedicated to critical issues in young women with breast cancer.

*This is a partial list of some cancer support organizations. These cancer organizations are not controlled by, endorsed by, or affiliated with Genentech, Inc. This list is meant for information purposes only and is not intended to replace your care professional’s medical advice. Ask your doctor or your healthcare team any questions you have about your cancer or treatment plan.

Know what to ask your doctor
Back to Top

Important Safety Information & Uses

PERJETA

PHESGO

KADCYLA

What does PERJETA treat?

PERJETA® (pertuzumab) is a prescription medicine approved for use in combination with Herceptin® (trastuzumab) and chemotherapy for:

  • use prior to surgery (neoadjuvant treatment) in people with HER2-positive, locally advanced, inflammatory, or early stage breast cancer (tumor is greater than 2 cm in diameter or node-positive). PERJETA should be used as part of a complete treatment regimen for early breast cancer.
  • use after surgery (adjuvant treatment) in people with HER2-positive early breast cancer that has a high likelihood of coming back.

What should I know about side effects with PERJETA?

  • Not all people have serious side effects; however, side effects with PERJETA therapy are common. It is important to know what side effects may happen and what symptoms you should watch for
  • Your doctor may stop treatment if serious side effects happen. Be sure to contact your healthcare team right away if you have questions or are worried about any side effects

What are the most serious side effects of PERJETA?

PERJETA may cause heart problems, including those without symptoms (such as reduced heart function) and those with symptoms (such as congestive heart failure).

  • Your doctor may run tests to monitor your heart function before and during treatment with PERJETA
  • Based on test results, your doctor may hold or discontinue treatment with PERJETA
  • Contact a health care professional immediately for any of the following: new onset or worsening shortness of breath, cough, swelling of the ankles/legs, swelling of the face, palpitations, weight gain of more than 5 pounds in 24 hours, dizziness or loss of consciousness

Receiving PERJETA during pregnancy can result in the death of an unborn baby and birth defects.

  • Birth control should be used while receiving PERJETA and for 7 months after your last dose of PERJETA. If you are a mother who is breastfeeding, you should talk with your doctor about either stopping breastfeeding or stopping PERJETA
  • If you think you may be pregnant, you should contact your healthcare provider immediately
  • If you are exposed to PERJETA during pregnancy, or become pregnant while receiving PERJETA or within 7 months following the last dose of PERJETA in combination with Herceptin, you are encouraged to report PERJETA exposure to Genentech at 1-888-835-2555

What are other possible serious side effects?

  • PERJETA should not be used in patients who are allergic to pertuzumab or to any of the ingredients in PERJETA
  • Infusion-related reactions: PERJETA is a medicine that is delivered into a vein through a needle. PERJETA has been associated with infusion-related reactions, some fatal. The most common infusion-related reactions when receiving PERJETA, Herceptin, and docetaxel were feeling tired, abnormal or altered taste, allergic reactions, muscle pain, and vomiting. The most common infusion-related reactions when receiving PERJETA alone were fever, chills, feeling tired, headache, weakness, allergic reactions, and vomiting
  • Severe allergic reactions: Some people receiving PERJETA may have severe allergic reactions, called hypersensitivity reactions or anaphylaxis, which may happen quickly and may affect many areas of the body. Severe allergic reactions, some fatal, have been observed in patients treated with PERJETA

What are the most common side effects?

  • The most common side effects of PERJETA when given with Herceptin and chemotherapy as part of an early breast cancer regimen before surgery are:
  • Constipation
  • Damage to the nerves (numbness, tingling, pain in hands/feet) 
  • Diarrhea
  • Feeling tired 
  • Hair loss 
  • Headache
  • Low levels of red blood cells 
  • Low levels of white blood cells with or without fever 
  • Low platelet count 
  • Mouth blisters or sores 
  • Nausea
  • Pain in the muscles 
  • Vomiting
  • Weakness 

Side effects may vary based on chemotherapy regimen.

The most common side effects of PERJETA when given with Herceptin and chemotherapy as part of an early breast cancer regimen after surgery are:

  • Diarrhea 
  • Nausea 
  • Hair Loss 
  • Feeling tired 
  • Damage to the nerves (numbness, tingling, pain in hands/feet)
  • Vomiting

You are encouraged to report side effects to Genentech and the FDA. You may report side effects to the FDA at 1-800-FDA-1088 or www.fda.gov/medwatch. You may also report side effects to Genentech at 1-888-835-2555.

Talk to a healthcare professional for more information about the benefits and risks of PERJETA.

Please see full Prescribing Information for additional Important Safety Information, including most serious side effects.

If you cannot afford your medication, visit genentech-access.com/patient for financial assistance information.

What does PHESGO treat?

PHESGO® (pertuzumab, trastuzumab, and hyaluronidase-zzxf) is a prescription medicine approved for use in combination with chemotherapy for:

  • use prior to surgery (neoadjuvant treatment) in adults with HER2-positive, locally advanced, inflammatory, or early stage breast cancer (tumor is greater than 2 cm in diameter or node-positive). PHESGO should be used as part of a complete treatment regimen for early breast cancer. 
  • use after surgery (adjuvant treatment) in adults with HER2-positive early breast cancer that has a high likelihood of coming back.

What should I know about side effects with PHESGO?

  • Not all people have serious side effects; however, side effects with PHESGO therapy are common. It is important to know what side effects may happen and what symptoms you should watch for
  • Your doctor may stop treatment if serious side effects happen. Be sure to contact your healthcare team right away if you have questions or are worried about any side effects

What are the most serious side effects of PHESGO?

PHESGO may cause heart problems, including those without symptoms (such as reduced heart function) and those with symptoms (such as congestive heart failure).

  • The risk for and seriousness of these heart problems are highest in people who received both PHESGO and a certain type of chemotherapy (anthracycline)
  • Your doctor will check for signs of heart problems before, during, and after treatment with PHESGO. Based on test results, your doctor may hold or discontinue treatment with PHESGO
  • Contact a healthcare professional immediately for any of the following: new onset or worsening shortness of breath, cough, swelling of the ankles/legs, swelling of the face, palpitations, weight gain of more than 5 pounds in 24 hours, dizziness or loss of consciousness

Receiving PHESGO during pregnancy can result in the death of an unborn baby and birth defects.

  • Birth control should be used while receiving PHESGO and for 7 months after your last dose of PHESGO. If you are a mother who is breastfeeding, you should talk with your doctor about either stopping breastfeeding or stopping PHESGO
  • If you think you may be pregnant, you should contact your healthcare provider immediately
  • If you are exposed to PHESGO during pregnancy, or become pregnant while receiving PHESGO or within 7 months following the last dose of PHESGO, you are encouraged to report PHESGO exposure to Genentech at 1-888-835-2555

PHESGO may cause serious lung problems.

  • Your doctor may check for signs of lung problems including:
    • Severe shortness of breath
    • Fluid in or around the lungs
    • Weakening of the valve between the heart and the lungs
    • Not enough oxygen in the body
    • Swelling of the lungs
    • Scarring of the lungs

Who should not receive PHESGO?

  • PHESGO should not be used in patients who are allergic to pertuzumab, trastuzumab, hyaluronidase, or to any of the ingredients in PHESGO

What are other possible serious side effects?

  • PHESGO may worsen low white blood cell counts caused by chemotherapy: Low white blood cell counts can be life threatening and were seen more often in patients receiving Herceptin® (trastuzumab) plus chemotherapy than in patients receiving chemotherapy alone. Your doctor may check for signs of low white blood cell counts when he or she examines you 
  • PHESGO may cause administration-related reactions: PHESGO is given as an injection. The active ingredients in PHESGO have been associated with severe administration reactions, including hypersensitivity or anaphylaxis, which can be fatal. Talk to your doctor if you feel any symptoms. The most common symptoms include dizziness, nausea, chills, fever, vomiting, diarrhea, hives, swelling of the skin, breathing problems, or chest pain

What are the most common side effects?

The most common side effects of PHESGO when given with chemotherapy as part of an early breast cancer regimen are:

  • Hair Loss
  • Nausea
  • Diarrhea
  • Low levels of red blood cells
  • Weakness

You are encouraged to report side effects to Genentech and the FDA. You may report side effects to the FDA at 1-800-FDA-1088 or www.fda.gov/medwatch. You may also report side effects to Genentech at 1-888-835-2555.

Talk to a healthcare professional for more information about the benefits and risks of PHESGO.

Please see full Prescribing Information for additional Important Safety Information, including most serious side effects.

If you cannot afford your medication, visit genentech-access.com/patient for financial assistance information

Who is KADCYLA for?

Early Breast Cancer

KADCYLA is a prescription medicine used as an adjuvant (after surgery) treatment for HER2-positive early breast cancer when the patient has taken neoadjuvant (before surgery) treatment including a taxane and trastuzumab (Herceptin®) and there is cancer remaining in the tissue removed during surgery.

Patients are selected for therapy based on an FDA-approved test for KADCYLA.

What is the most Important Safety Information I should know about KADCYLA?

Liver problems

  • KADCYLA may cause severe liver problems that can be life-threatening. Symptoms of liver problems may include vomiting, nausea, eating disorder (anorexia), yellowing of the skin (jaundice), stomach pain, dark urine, or itching

Heart problems

  • KADCYLA may cause heart problems, including those without symptoms (such as reduced heart function) and those with symptoms (such as congestive heart failure). Symptoms may include swelling of the ankles or legs, shortness of breath, cough, rapid weight gain of more than 5 pounds in 24 hours, dizziness or loss of consciousness, or irregular heartbeat

Pregnancy

  • Receiving KADCYLA during pregnancy can result in the death of an unborn baby and birth defects. Birth control should be used while you receive KADCYLA and for 7 months after your last dose of KADCYLA
  • If you think you may be pregnant, you should contact your healthcare provider immediately
  • If you are exposed to KADCYLA during pregnancy or if you become pregnant within 7 months following your last dose of KADCYLA, you are encouraged to report KADCYLA exposure to Genentech by calling 1-888-835-2555
  • If you are a male patient with a female partner that could become pregnant, birth control should be used during treatment and for 4 months following your last dose of KADCYLA
  • You should not breastfeed during treatment and for 7 months after the last dose of KADCYLA

Contact your doctor right away if you experience symptoms associated with these side effects.

What are the additional possible serious side effects of KADCYLA?

Lung problems

  • KADCYLA may cause lung problems, including inflammation of the lung tissue, which can be life-threatening. Signs of lung problems may include trouble breathing, cough, tiredness, and fluid in the lungs

Infusion-related reactions

  • Symptoms of an infusion-related reaction may include one or more of the following: the skin getting hot or red (flushing), chills, fever, trouble breathing, low blood pressure, wheezing, tightening of the muscles in the chest around the airways, or a fast heartbeat. Your doctor will monitor you for infusion-related reactions

Serious bleeding

  • KADCYLA can cause life-threatening bleeding. Taking KADCYLA with other medications used to thin your blood (antiplatelet) or prevent blood clots (anticoagulation) can increase your risk of bleeding. Your doctor should provide additional monitoring if you are taking one of these other drugs while on KADCYLA. Even when blood thinners are not also being taken, life-threatening bleeding may occur with KADCYLA

Low platelet count

  • Low platelet count may happen during treatment with KADCYLA. Platelets help your blood to clot. Signs of low platelets may include easy bruising, bleeding, and prolonged bleeding from cuts. In mild cases there may not be any symptoms

Nerve damage

  • Symptoms may include numbness and tingling, burning or sharp pain, sensitivity to touch, lack of coordination, muscle weakness, or loss of muscle function. Your doctor will monitor you for symptoms of nerve damage

Skin reactions around the infusion site

  • KADCYLA may leak from the vein or needle and cause reactions such as redness, tenderness, skin irritation, or pain or swelling at the infusion site. If this happens, it is more likely to happen within 24 hours of the infusion

What are the most common side effects of KADCYLA?

The most common side effects in people taking KADCYLA for early breast cancer are:

  • Tiredness
  • Nausea
  • Liver problems
  • Pain that affects the bones, muscles, ligaments, and tendons
  • Bleeding
  • Low platelet count
  • Headache
  • Weakness, numbness, and pain in the hands and feet
  • Joint pain

You are encouraged to report side effects to Genentech and the FDA. You may contact Genentech by calling 1-888-835-2555. You may contact the FDA by visiting www.fda.gov/medwatch or calling 1-800-FDA-1088.

Talk to a healthcare professional for more information about the benefits and risks of KADCYLA.

Please see full Prescribing Information for additional Important Safety Information, including most serious side effects.

If you cannot afford your medication, visit genentech-access.com/patient for financial assistance information.

  • Adjuvant treatment

    The treatment that is given after surgery to kill any remaining cancer cells and lower your risk of the cancer returning. The goal of adjuvant treatment is to keep you cancer-free for as long as possible.

  • Chemotherapy

    A type of medication that kills cells that grow and divide rapidly, including cancer cells and normal cells.

  • Cycle

    A cycle is a course of treatment that is repeated on a regular schedule with periods of rest in between.

  • HER2 status

    HER2 stands for human epidermal growth factor receptor 2. HER2 is a type of protein found on the surface of cells in everyone that tells the cells to grow and divide. When breast cancer cells have too many HER2 receptors, they are called HER2-positive (HER2+).

  • Inflammatory

    When the breast is swollen, red, or inflamed as a result of the cancer cells blocking lymph vessels.

  • Infusion

    A method of putting fluids, including drugs, into the bloodstream. Also called intravenous infusion.

  • Lymph nodes

    Small, bean-shaped organs found throughout the body that store white blood cells and help remove cell waste, germs, and other harmful substances from the body.

  • Node positive

    This means your doctor has detected cancer cells in one or more of your lymph nodes.

  • Nodal status

    Cancer cells can sometimes appear in nearby structures known as "lymph nodes." When cancer cells appear in one or more lymph nodes, the cancer is said to be "node-positive" (node+).

  • Neoadjuvant treatment

    Treatment given before surgery to help reduce or get rid of cancer cells before surgery.

  • Pathologic complete response (pCR)

    A pCR means that no cancer cells were found in the tissue removed during surgery. A pCR is not the same as a cure.

  • Port

    A surgically implanted disc through which blood can be taken and medication can be given without repeated needle sticks

  • Residual disease

    If cancer cells are found in the tissue removed during surgery, it is known as residual disease.

  • Targeted therapies

    Designed to target specific characteristics of cancer cells. Targeted treatments may also affect normal cells

  • Tumor size

    The size of the tumor is how large it is at its widest point.

  • Hormone receptor status

    Two hormones naturally made by the body are called estrogen and progesterone. These hormones attach to hormone receptors on cells. Some tumors have hormone receptors—they can have estrogen receptors, progesterone receptors, or both. This is called “hormone receptor-positive” breast cancer. “Hormone receptor-negative” breast cancer is when the cancer cells do not have hormone receptors.

  • Hyaluronidase

    Hyaluronidase is a protein naturally found in most tissues of the body and helps enhance the way the body absorbs medicines injected under the skin. When PHESGO is injected, the hyaluronidase makes the tissue under the skin more absorbent temporarily so that it’s able to receive the medication.

  • Locally advanced

    Cancer that has spread from where it started to nearby tissue or lymph nodes.

  • Early-stage breast cancer

    Breast cancer that has not spread beyond the breast or the axillary lymph nodes.

  • HER2-targeted therapies

    A type of targeted cancer treatment that binds to HER2 receptors to fight cancer cells that have too many HER2 receptors.

  • Surgery

    The medical practice of treating injuries or disease by cutting into the body to physically remove tissue.