Is paclitaxel + trastuzumab and pertuzumab an effective treatment combination in breast cancer?

This paper investigated the safety and efficacy of pertuzumab (Perjeta) and trastuzumab (Herceptin) with paclitaxel (Taxol) given once per week. 

Human epidermal growth factor receptor 2 is a protein that can be found on some cancer cells. Drugs that target HER2 has shown to be effective in improving survival in those patients with abnormally high levels of HER2. Trastuzumab and pertuzumab are such drugs. A previous study showed greatly improved survival when pertuzumab was added to trastuzumab and docetaxel (Taxotere; a form of chemotherapy). However, previous studies have also shown that  paclitaxel given once per week is more effective and less toxic than docetaxel. 

The authors aimed to evaluate how effective and safe trastuzumab and pertuzumab were when administered with paclitaxel. 67 patients with HER2 positive (present) breast cancer who received 80mg/m² of paclitaxel once per week plus trastuzumab and pertuzumab once every 3 weeks were analyzed.

The average follow-up time was 21 months. The 6-month progression free survival (no worsening of disease at 6 months) was 86%. The 6-month progression free survival was 89% for those without previous treatment and 78% for those with previous treatment. The average length of progression-free survival was 19.5 months. The 1-year estimate for patients alive and without worsening disease was 70%. Of 64 patients, 11% had a complete response (disappearance of all signs of cancer), 48% had a partial response (decrease in extent of cancer) and 25% had stable disease (no change in cancer).

With regards to safety, overall, treatment was well tolerated. 6% of patients experienced fatigue. One patient was hospitalized for sepsis (severe complication of infection) and one patient was hospitalized for abnormal magnesium levels.

The authors concluded that paclitaxel given once per week with trastuzumab and pertuzumab is an effective and safe alternative to treatment with docetaxel in combination with other drugs. 

Discuss with your doctor about receiving paclitaxel plus trastuzumab and pertuzumab.