Breast Cancer Coverage from Every Angle

Subcutaneous Versus Intravenous Pertuzumab/Trastuzumab in Early Breast Cancer: Patient Perspective

By: Anna Nowogrodzki
Posted: Tuesday, August 11, 2020

A total of 82% of patients with HER2-positive early breast cancer preferred a combination of pertuzumab and trastuzumab to be administered subcutaneously rather than intravenously, according to an interim analysis of the open-label, randomized PHranceSCa trial. Joyce O’Shaughnessy, MD, of Baylor University Medical Center, Dallas, and colleagues published the findings in Annals of Oncology.

“The safety profile was consistent with intravenous pertuzumab plus trastuzumab, and no new safety signals were seen,” wrote the authors.

The investigators treated 118 patients with histologically confirmed HER2-positive early breast cancer with six cycles of pertuzumab plus trastuzumab every 6 weeks: half intravenously (n =56) and half subcutaneously (n = 62). Patients were randomly assigned to receive either 3 weeks of intravenous treatment first or 3 weeks of subcutaneous treatment first. Afterward, patients chose either intravenous or subcutaneous treatment, to complete up to 18 cycles of therapy total.

Of the 51 patients who completed both formulations of therapy, 42 (82%) preferred subcutaneous to intravenous treatment. All patients were female, with a median age of 49 years. Common reasons for patient preference of subcutaneous treatment included “less time in the clinic” (38 patients) and “more comfortable therapy administration” (22 patients).

Patients’ rates of systemic reaction to therapy were 2.6% (3 patients) for intravenous administration and 1.7% (2 patients) for subcutaneous administration. No patients had local reactions to intravenous administration, but 21 patients (18.1%) had local reactions to subcutaneous injection. While receiving intravenous therapy, one patient had a serious adverse event (pyrexia), and two had grade 3 adverse events (ejection-fraction decrease and lymphopenia). While receiving subcutaneous treatment, three patients had grade 3 adverse events (ejection-fraction decrease, diarrhea, and device-related infection). There were no treatment-related deaths reported.

Disclosure: The study authors’ disclosure information may be found at

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