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Old 07-20-2013, 11:49 AM   #1
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'lizbeth's Avatar
Join Date: Apr 2008
Location: Sunny San Diego
Posts: 2,214
How does Perjeta work?

Diagnosed 2007
Stage IIb Invasive Ductal Carcinoma, Pagets, 3 of 15 positive nodes

Traditional Treatment: Mastectomy and Axillary Node Dissection followed by Taxotere, 6 treatments and 1 year of Herceptin, no radiation
Former Chemo Ninja "Takizi Zukuchiri"

Additional treatments:
GP2 vaccine, San Antonio Med Ctr
Prescriptive Exercise for Cancer Patients
ENERGY Study, UCSD La Jolla

Reconstruction: TRAM flap, partial loss, Revision

The content of my posts are meant for informational purposes only. The medical information is intended for general information only and should not be used in any way to diagnose, treat, cure, or prevent disease
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Old 07-21-2013, 06:27 PM   #2
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Join Date: Sep 2012
Posts: 111
Re: How does Perjeta work?

Thanks for posting! I love the part at the end with the cancer disintegrating.

This is a great visual image -- I'm going to think of it every day!!


7/30/2012 Diagnosed with metastatic breast cancer
8/3/2012 CT scan mets to liver (major!!), lungs, spine, and skin
8/8/2012 Biopsy results: invasive ductal carcinoma
ER+/PR+/HER2+ amplification 4.8 (whatever that means)
8/13/2012 Brain MRI (clear); bone scan verified CT scan
8/14/12 started Taxotere/Carboplatin/Herceptin, 2 rounds (added Neulasta after 9/4 treatment)
9/4/12 CA 15-3: >3000
9/15/12 CA 15-3: 840
9/15/12 started Taxotere/Perjeta/Herceptin, 4 rounds (no Neulasta)
10/29/12 CT scan showed dramatic improvement in all areas - largest liver met 2.5 cm, largest lung met 10 cm
12/17/12 Started Perjeta/Herceptin, 2 rounds
12/17/12 CA 15-3: 17 Yay!!!
1/21/13 CT scan showed improvement - largest liver met 1.9 cm, largest lung met 2 mm
1/29/13 CA 15-3: 12 Started Herceptin only
3/12/13 CA 15-3: still 12 yay!! Back to Perjeta/Herceptin
3/29/13 CT scan more improvement - largest liver met 1.2 cm, some lung mets disappeared!
3/7/14 started Tamoxifen
6/27/13 - 1/2015 CT scan stable
Began a diet of only single ingredient foods and went nearly NED excepts for some tiny lung spots - ask me if you want to know more...
1/2015 - 1/2017 CT scan stable
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Old 07-21-2013, 07:24 PM   #3
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Join Date: Dec 2012
Location: Attica, IN
Posts: 371
Re: How does Perjeta work?

Yes, great visual! And I am a visual learner.
myleftlump.wordpress.com - started blogging my
IDC breast cancer
7/2012 diagnosed with multiple solid lesions
7/20/12 biopsy done. ER+ 30 PR -, HER+++,k167 80% Grade 2
9/2012 biopsy on lymph node - showed malignant

9/2012 Pre-adjunctive TCH chemo.

12/6/12 MRI after Pre-adj.
Results: Modest Decrease in size of left breast malignancy As well as the associated satellite lesions and auxiliary Adenopathy compared to prior study. Doctors hoped for better but good response it didn't grow.

12/18/2012 left masectomy with axillary nodes
Size 3.2 CM, Nottingham score 9/9
Grade 3, no evidence of in situ carcinoma
Areas of angiolymphatic are identified
Carcinoma is 0.5 cm from inked deep
Margin of excision
Attached axillary lymph nodes: metastatic
Carcinoma in 6 of 8 nodes.
Size of largest node 1.5 cm
ER + 73%, PR+2%, HER2+

2/27/13 6 weeks of IMRT radiation finished

2/2013 Started on Tamoxifan 5 years.

8/2013 will take last Herceptin, 17 treatments total every 3 weeks.

BRCA1 & BRAC2 - Negative

August 28, 2013 DIEP flap on the left breast.
February 2014 Nip & Tuck
March 14, 2014 nipple reconstruction and removed port.
August 14, 2014 lump in lymph nodes under arm and above clavicle. Stage IV
August 28, 2014 herceptin And projeta starting and port put back in.

3/18/15 stopped arimidex.
3/18/15 progression....Tdm1
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Old 12-05-2014, 08:55 PM   #4
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Join Date: Jan 2010
Location: Edmonds, WA
Posts: 202
Re: How does Perjeta work?

It is my understanding that Herceptin and Perjeta are both targeted therapies for HER2+ breast cancer. They both attack the HER2 cells, however that attack them in different ways that are believed to make the chance of recurrence substantially less. This is the definition I got from my onc and I have a lot of faith in what he has to say. Neither of these drugs have very harsh side effects and adding Perjeta does not appear to increase the risk of any cardiac issues. So compared to a lot of the therapies out there this one appears pretty mild.
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Old 12-21-2014, 01:11 PM   #5
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Join Date: Jan 2010
Location: Edmonds, WA
Posts: 202
Re: How does Perjeta work?

Thanks for posting this video. It does a great job of explaining the synergy between Herceptin and Perjeta. I kind of understood it and this really makes it clearer.
Diagnosed June, 2006 HER2+++, ER- PR-, Grade 3, Stage IIB. Modified radical mastectomy, radiation, chemo, Herceptin, Tykerb 1 year. [*]In remission until 2/2010. Small tumor detected on chest wall during routine scan. 2/2010 surgery to remove tumor, started Herceptin/Tykerb, follow up radiation. [*]12/26/2010 - Off Tykerb due to allergic reaction[*]12/16/2014 - Have continued on Herception for almost 5 years now and remain NED. Discussion with onc re adding Perjeta to the Herceptin as another way of preventing recurrence. Still in discussion phase. 12/26/14 Onc applying for approval for Perjeta.
Perjeta approved and I received one infusion. It had an immediate impact to my lungs and I experienced difficulty breathing so.....I'm going to be sticking with just Herceptin. Still looking for a good vaccine program to enroll in.

Debbie K
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Old 08-18-2015, 03:47 AM   #6
Marko Skoric
Join Date: Jul 2015
Posts: 22
Wink Re: How does Perjeta work?

Thank for the information.
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Old 08-18-2015, 03:15 PM   #7
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Join Date: Oct 2013
Posts: 265
Re: How does Perjeta work?

Perjeta works by preventing the dimerization (linking) of the Her 2 protein with Her3 and Her 4 proteins. When the Her 2 protein links with the other growth factors, certain signal mechanisms like Map Kinase and PI-3K start a chain of events (A-B-C-D-E-F etc ) that ultimately reach the cell nucleus and initiate cell growth. This A-B-C-etc- to cell growth is known as signal transduction. Perjeta by preventing the dimerization process decreases this. Hope this helps.

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