PERJETA Access Solutions

We are dedicated to helping you understand your insurance coverage and assistance options. This can help you get the Genentech medicine your doctor prescribed.

Ready to Enroll?

Fill out the Patient Consent Form and send it to PERJETA Access Solutions to get started. The form can be submitted in any of these 3 ways:

Download and fax

Fax your completed and signed form to PERJETA Access Solutions

Submit online

Fill out and submit the form online

Text a photo

Take a photo of your signed form and text it to PERJETA Access Solutions

Important Safety Information & Indication

What it Treats

What does PERJETA treat?

  • PERJETA® (pertuzumab) is approved for use in combination with Herceptin® (trastuzumab) and docetaxel in people who have HER2-positive breast cancer that has spread to different parts of the body (metastatic) and who have not received anti-HER2 therapy or chemotherapy for metastatic breast cancer.

PERJETA® (pertuzumab) is 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.

Important Safety Information

  • 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
    • 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 enroll in the MotHER Pregnancy Registry by contacting 1-800-690-6720 or visiting http://www.motherpregnancyregistry.com/ and report PERJETA exposure to Genentech at 1-888-835-2555
  • PERJETA should not be used in patients who are allergic to pertuzumab or to any of the ingredients in PERJETA
  • Other possible serious and sometimes fatal side effects of PERJETA therapy include:
    • Infusion-related reactions
    • Severe allergic reactions (hypersensitivity reactions/anaphylaxis)
  • The most common side effects of PERJETA when given with Herceptin and docetaxel for treatment of breast cancer that has spread to other parts of the body (metastatic) are:
    • Diarrhea
    • Hair loss
    • Low levels of white blood cells with or without fever
    • Nausea
    • Feeling tired
    • Rash
    • Damage to the nerves (numbness, tingling, pain in hands/feet)
  • 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 http://www.fda.gov/medwatch. You may also report side effects to Genentech at 1-888-835-2555.

Please see full Prescribing Information for additional Important Safety Information, including most serious side effects.