[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Pharmacology](https://durgical.com/en/pharmacology/) › [Antineoplastic monoclonal antibodies](https://durgical.com/en/pharmacology/classes/antineoplastic-monoclonal-antibodies/) › Pertuzumab # Pertuzumab ## Antineoplastic monoclonal antibodies? Antineoplastic monoclonal antibodies ## High alert? An error with this medicine can cause serious harm: double checks and protocols are used. ## Pregnancy: avoid? Avoid in pregnancy. Can cause fetal harm; a pregnancy test is done before starting, and effective contraception is used during treatment and for several months after. Anti-HER2 antibody that blocks HER2 pairing with other HER receptors. Given with trastuzumab in HER2-positive breast cancer; watch the heart. Updated Nov 1, 2026 ## Quick facts **Group** [Antineoplastic monoclonal antibodies](https://durgical.com/en/pharmacology/classes/antineoplastic-monoclonal-antibodies/) **Target** HER2 (ErbB2) receptor tyrosine kinase, extracellular dimerisation domain II **Used for** HER2-positive breast cancer **Key effects** Diarrhoea · Hair loss · Watery eyes **Monitor** Heart function · Pregnancy test before starting **ATC** L01FD02 No doses: the clinician sets them by the current guideline. On this page - The basics Mechanism of action - Indications - Adverse effects - Pharmacokinetics - Memory aid - Clinical What the labels mean - Safety Contraindications - Key interactions - What is monitored - Administration and safety - Pregnancy and breastfeeding - Nursing care - Study Test yourself - Connections Connections ## Mechanism of action ◎**HER2 (ErbB2) receptor tyrosine kinase, extracellular dimerisation domain II**Pertuzumab ⓘ The crystal shows the extracellular region of human HER2 with the pertuzumab Fab bound to domain II, the arm HER2 uses to pair with other HER receptors. **Target in 3D:** HER2 (ErbB2) receptor tyrosine kinase, extracellular dimerisation domain II. PDB structure 1S78 (RCSB PDB, public domain). [View the structure at RCSB PDB](https://www.rcsb.org/structure/1S78) · Drag to rotate · pinch to zoom Pertuzumab is a humanised IgG1 antibody that binds domain II of HER2, a different site from trastuzumab, which binds domain IV. Domain II is where HER2 pairs with HER3 and other HER receptors, so pertuzumab stops ligand-driven heterodimers from forming and from sending growth and survival signals. Bound to the tumour cell, it can also trigger antibody-dependent cellular cytotoxicity. Using both antibodies blocks HER2 more completely than either alone. - Pertuzumab binds HER2 domain II (trastuzumab binds domain IV) - HER2 can no longer pair with HER3 and other HER receptors - Growth and survival signalling stops; immune cells attack ## Indications - HER2-positive breast cancer (early, locally advanced, inflammatory or metastatic), with trastuzumab and chemotherapy such as docetaxel. [Breast cancer →](https://durgical.com/en/conditions/breast-cancer/) ## Adverse effects ### Common - Diarrhoea, nausea, mouth sores - Hair loss, dry skin, nail changes - Numbness or tingling in the hands and feet - Watery eyes, loss of appetite, trouble sleeping ### Serious (rare, important) - Left ventricular dysfunction and heart failure - Infusion and allergic reactions, including anaphylaxis - Embryo-fetal harm - Infections, and tiredness or pale skin from anaemia ## Contraindications - Use at the same time as cardiotoxic anthracyclines ## Key interactions **Anthracyclines (e.g., doxorubicin)** Add cardiotoxicity to the HER2 blockade; pertuzumab is not combined with cardiotoxic anthracyclines at the same time. **Trastuzumab** Intended combination: the two antibodies bind different HER2 domains and their effects add up, as do the heart risks. ## What is monitored - Heart function (ejection fraction) before and during treatment - HER2 test on the tumour before starting - Pregnancy test before starting in women who could be pregnant - Vital signs during and after each infusion ## Administration and safety - Intravenous infusion by a doctor or nurse; the patient is observed during and after each infusion. - The subcutaneous pertuzumab-trastuzumab-hyaluronidase product is a different preparation and is not swapped for the intravenous ones. ## Pregnancy and breastfeeding Avoid in pregnancy. Can cause fetal harm; a pregnancy test is done before starting, and effective contraception is used during treatment and for several months after. ## Nursing care - Confirm a recent heart function test before each phase of treatment. - Teach the patient to report breathlessness, cough, swollen ankles, rapid heartbeat or sudden weight gain. - Watch for swelling of the face, wheeze, fever or chills during the infusion. - Teach effective contraception during treatment and for months after the last dose. ## Pharmacokinetics **Absorption** Intravenous infusion; a combined product with trastuzumab and hyaluronidase is injected under the skin. **Half-life** Long, about 18 days (median), which allows dosing every three weeks. ## Memory aid PERtuzumab PAIRS with no one: it grabs the dimerisation arm (domain II), while trastuzumab holds domain IV. Two hands on HER2 — check the heart twice. ## Test yourself Think of the answer, then tap the question to see it. ## How do pertuzumab and trastuzumab differ in where they bind HER2? Pertuzumab binds domain II (dimerisation); trastuzumab binds domain IV. ## Which test must be done before and during pertuzumab treatment? Heart function (left ventricular ejection fraction), because it can cause heart failure. ## Which tumour test decides whether pertuzumab can be used? HER2 testing: it is only for HER2-positive breast cancer. [Add to my cards (3)](https://durgical.app/estudiar/?add=/en/pharmacology/pertuzumab/) [More Pharmacology questions →](https://durgical.com/en/practice/?f=pharmacology) ## What the labels mean **High alert** An error with this medicine can cause serious harm: double checks and protocols are used. **Pregnancy: avoid** Avoid in pregnancy. Can cause fetal harm; a pregnancy test is done before starting, and effective contraception is used during treatment and for several months after. ## Connections ## Related drugs 2 - [Trastuzumab](https://durgical.com/en/pharmacology/trastuzumab/) - [Docetaxel](https://durgical.com/en/pharmacology/docetaxel/) ## Related conditions 1 - [Breast cancer](https://durgical.com/en/conditions/breast-cancer/) [← Back to the class: Antineoplastic monoclonal antibodies](https://durgical.com/en/pharmacology/classes/antineoplastic-monoclonal-antibodies/) Educational content on how drugs work; not a prescribing guide and no substitute for a health professional's advice. No doses are given. Sources: [Pertuzumab Injection: MedlinePlus Drug Information](https://medlineplus.gov/druginfo/meds/a612027.html) (MedlinePlus (U.S. National Library of Medicine), 2026); [ATCDDD - ATC/DDD Index](https://atcddd.fhi.no/atc_ddd_index/?code=L01FD02) (WHO Collaborating Centre for Drug Statistics Methodology, 2026); [Insights into ErbB signaling from the structure of the ErbB2-pertuzumab complex](https://www.rcsb.org/structure/1S78) (RCSB Protein Data Bank, 2004). ## **Spotted a mistake?** We are always improving for the community. Tell us what is wrong and our team will review it. Report a mistake Representative model, for educational purposes only. --- Source: https://durgical.com/en/pharmacology/pertuzumab/ License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/pharmacology/pertuzumab/