Starting treatment after surgery to help lower the chance of cancer coming back

Based on your answers, here is information about starting treatment for the first time after surgery.

One or more of these is true:

  • I have been diagnosed with breast cancer
  • The tumor is node positive, or larger than two centimeters
  • I did not receive neoadjuvant treatment
  • I will start treatment for the first time after surgery
Clear and start over

Quick Links

Prepare for a conversation with your doctor
Treatment options for you
If your doctor recommends PERJETA + Herceptin after surgery
If your doctor recommends PHESGO after surgery

Prepare for a conversation with your doctor

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

  • Can we discuss my treatment goals?
  • How might adjuvant treatment help me?
  • How will you know if my treatment is working?
  • When will I start adjuvant treatment?
Know what to ask your doctor
Back to Top

Treatment options for you

You may start treatment for the first time after surgery to help lower the chance of the cancer coming back

Your doctor may recommend one of the following:

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 used with Herceptin® (trastuzumab) and chemotherapy after surgery. 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 brings together 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.

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

A study examined starting treatment after surgery with PERJETA + Herceptin compared to a different treatment

Who was in the study?

4,804 people with certain types of HER2+ eBC who started treatment after surgery (adjuvant treatment).

What was the goal of the study?

To find out if people who took PERJETA + Herceptin + chemotherapy after surgery were less likely to have their cancer come back.

What were the results?

Adjuvant treatment with PERJETA + Herceptin + chemotherapy in 2,400 people lowered the risk of the cancer coming back by 18% when compared to Herceptin in 2,404 people.

Three years after starting the trial, most of the trial participants were still cancer-free, regardless of which treatment they had received. However, slightly more people in the group that had gotten PERJETA + Herceptin + chemotherapy were cancer-free (94.1%), compared with the other group (93.2%).

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

What are other possible serious side effects of PERJETA?

PERJETA should not be used in patients who are allergic to pertuzumab or to any of the ingredients in PERJETA. Possible serious and sometimes fatal side effects of PERJETA include infusion-related reactions and severe allergic reactions (hypersensitivity reactions/anaphylaxis).

See additional Important Safety Information below.

Back to Top

If your doctor recommends PERJETA + Herceptin after surgery

Infusion Bag icon

The dosing schedule is organized by cycle. Each cycle is 3 weeks long.

PERJETA + Herceptin treatment is up to 18 cycles in total (about 1 year) unless the cancer comes back sooner or side effects require the treatment to stop.

Know what to ask your doctor
Back to Top

Discover study results with PHESGO

  • See clinical trial results
  • Find out if more people preferred PHESGO or PERJETA + Herceptin
Visit PHESGO.com

If your doctor recommends PHESGO after surgery

Injection icon

The dosing schedule is organized by cycle. Each cycle is 3 weeks long.

PHESGO treatment is up to 18 cycles in total (about 1 year) unless the cancer comes back sooner or requires the treatment to stop.

Back to Top

Summarizing the key differences between these two treatments

  PERJETA + Herceptin PHESGO
Active ingredients pertuzumab trastuzumab pertuzumab trastuzumab hyaluronidase
Administration method Intravenous (IV) infusion, given by a care provider Subcutaneous (under the skin) injection, given by a care provider
Administration time

About 1-2.5 hours*:

  1. PERJETA infusions take 30-60 minutes
  2. Herceptin infusions take 30-90 minutes
 Your first dose is given in about 8 minutes. Other injections take about 5 minutes.*
Study results summary

A study comparing PHESGO to PERJETA + Herceptin found no major difference is expected in how well PHESGO works. By taking PHESGO, you’re taking the same medicines, just in less time.

There are side effects associated with both treatments. The comparison study did not find any significant difference between the 2 treatments.

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

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.

Conversation speech bubbles icon

You can start the conversation

Know what to ask your doctor

Discover the treatment experience

See potential pathways
Back to Top

Explore these HER2-targeted therapies

Visit PERJETA.com
Visit PHESGO.com
Back to Top

Important Safety Information & Uses

PERJETA

PHESGO

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

  • 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.