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Pertuzumab, Trastuzumab, and Hyaluronidase-zzxf

Class: Antineoplastic Agents
Brands: Phesgo

Medically reviewed by Drugs.com on Aug 3, 2020. Written by ASHP.

Warning

WARNING: CARDIOMYOPATHY, EMBRYO-FETAL TOXICITY, and PULMONARY TOXICITY

See full prescribing information for complete boxed warning.

  • Cardiomyopathy: Fixed combination of pertuzumab, trastuzumab, and hyaluronidase-zzxf administration can result in subclinical and clinical cardiac failure manifesting as CHF, and decreased LVEF, with greatest risk when administered concurrently with anthracyclines. Evaluate cardiac function prior to and during treatment. Discontinue the fixed combination of pertuzumab, trastuzumab, and hyaluronidase-zzxf for cardiomyopathy.

  • Embryo-fetal Toxicity: Exposure to the fixed combination of pertuzumab, trastuzumab, and hyaluronidase-zzxf can result in embryo-fetal death and birth defects. Advise patients of these risks and the need for effective contraception.

  • Pulmonary Toxicity: Discontinue the fixed combination of pertuzumab, trastuzumab, and hyaluronidase-zzxf for anaphylaxis, angioedema, interstitial pneumonitis, or acute respiratory distress syndrome.

Introduction

The fixed combination of pertuzumab, trastuzumab, and hyaluronidase-zzxf is an antineoplastic agent.

Uses for Pertuzumab, Trastuzumab, and Hyaluronidase-zzxf

Fixed combination of pertuzumab, trastuzumab, and hyaluronidase-zzxf has the following uses:

Pertuzumab, trastuzumab, and hyaluronidase-zzxf is a fixed combination of pertuzumab and trastuzumab, HER2/neu receptor antagonists, and hyaluronidase, an endoglycosidase, indicated for use in combination with chemotherapy as neoadjuvant treatment of patients with HER2-positive, locally advanced, inflammatory, or early stage breast cancer (either greater than 2 cm in diameter or node-positive) as part of a complete treatment regimen for early breast cancer; or as adjuvant treatment of patients with HER2-positive early breast cancer at high risk of recurrence.

The fixed combination of pertuzumab, trastuzumab, and hyaluronidase-zzxf also is used in combination with docetaxel for treatment of patients with HER2-positive metastatic breast cancer (MBC) who have not received prior anti-HER2 therapy or chemotherapy for metastatic disease.

Pertuzumab, Trastuzumab, and Hyaluronidase-zzxf Dosage and Administration

General

The fixed combination of pertuzumab, trastuzumab, and hyaluronidase-zzxf is available in the following dosage form(s) and strength(s):

Injection:

  • 1,200 mg pertuzumab, 600 mg trastuzumab, and 30,000 units hyaluronidase/15 mL (80 mg, 40 mg, and 2,000 units/mL) of solution in a single-dose vial.

  • 600 mg pertuzumab, 600 mg trastuzumab, and 20,000 units hyaluronidase/10 mL (60 mg, 60 mg, and 2,000 units/mL) of solution in a single-dose vial.

Dosage

It is essential that the manufacturer's labeling be consulted for more detailed information on dosage and administration of this drug. Dosage summary:

Adults

Dosage and Administration
  • For subcutaneous use in the thigh only.

  • Fixed combination of pertuzumab, trastuzumab, and hyaluronidase-zzxf (Phesgo) has different dosage and administration instructions than IV pertuzumab and trastuzumab products when administered alone. Do not substitute the fixed combination product for or with pertuzumab, trastuzumab, ado-trastuzumab emtansine, or fam-trastuzumab deruxtecan.

  • Do not administer IV.

  • Perform HER2 testing using FDA-approved tests by laboratories with demonstrated proficiency.

  • The initial dose of fixed combination pertuzumab, trastuzumab, and hyaluronidase-zzxf is 1200 mg pertuzumab, 600 mg trastuzumab, and 30,000 units hyaluronidase administered subcutaneously over approximately 8 minutes, followed every 3 weeks by a dose of 600 mg pertuzumab, 600 mg trastuzumab, and 20,000 units hyaluronidase administered subcutaneously over approximately 5 minutes.

  • Neoadjuvant treatment of breast cancer: Administer fixed combination pertuzumab, trastuzumab, and hyaluronidase-zzxf by subcutaneous injection every 3 weeks and chemotherapy by IV infusion preoperatively for 3 to 6 cycles.

  • Adjuvant treatment of breast cancer: Administer fixed combination pertuzumab, trastuzumab, and hyaluronidase-zzxf by subcutaneous injection every 3 weeks and chemotherapy by IV infusion postoperatively for a total of 1 year (up to 18 cycles).

  • MBC: Administer fixed combination pertuzumab, trastuzumab, and hyaluronidase-zzxf by subcutaneous injection and docetaxel by IV infusion every 3 weeks.

Cautions for Pertuzumab, Trastuzumab, and Hyaluronidase-zzxf

Contraindications

  • Known hypersensitivity to pertuzumab, or trastuzumab, or hyaluronidase, or to any of its excipients.

Warnings/Precautions

Cardiomyopathy

The fixed combination of pertuzumab, trastuzumab, and hyaluronidase-zzxf can cause hypertension, arrhythmias, left ventricular cardiac dysfunction, disabling cardiac failure, cardiomyopathy, and cardiac death. The fixed combination of pertuzumab, trastuzumab, and hyaluronidase-zzxf can cause asymptomatic decline in LVEF.

In the FeDeriCa study, the percentage of patients with at least one cardiac disorder was 22% in the fixed-combination pertuzumab, trastuzumab, and hyaluronidase-zzxf arm. The most frequent cardiac adverse reaction in the fixed-combination pertuzumab, trastuzumab, and hyaluronidase-zzxf arm was ejection fraction decreased.

The incidence of cardiac failure (NYHA class III/IV) with a LVEF decline ≥ 10% and a drop to <50% was 0.8% in the fixed-combination pertuzumab, trastuzumab, and hyaluronidase-zzxf arm. Confirmed asymptomatic or mildly symptomatic (NYHA class II) declines in LVEF ≥ 10% and a drop to <50% was 1.2% in the fixed-combination pertuzumab, trastuzumab, and hyaluronidase-zzxf arm.

The fixed combination of pertuzumab, trastuzumab, and hyaluronidase-zzxf and/or IV pertuzumab and trastuzumab have not been studied in patients with a pretreatment LVEF value of <55% (early breast cancer) or <50% (MBC); a prior history of CHF, conditions that could impair left ventricular function such as uncontrolled hypertension, recent myocardial infarction, serious cardiac arrhythmia requiring treatment or a cumulative prior anthracycline exposure to >360 mg/m2 of doxorubicin or its equivalent.

An increased incidence of LVEF decline has been observed in patients treated with IV pertuzumab, IV trastuzumab, and docetaxel. A 4-6 fold increase in the incidence of symptomatic myocardial dysfunction has been reported among patients receiving trastuzumab, with the highest absolute incidence occurring when trastuzumab was administered with an anthracycline.

Patients who receive anthracycline after stopping the fixed combination of pertuzumab, trastuzumab, and hyaluronidase-zzxf may also be at increased risk of cardiac dysfunction.

Cardiac Monitoring

Prior to initiation of the fixed combination of pertuzumab, trastuzumab, and hyaluronidase-zzxf, conduct a thorough cardiac assessment, including history, physical examination, and determination of LVEF by echocardiogram or MUGA scan.

During treatment with the fixed combination of pertuzumab, trastuzumab, and hyaluronidase-zzxf, assess LVEF at regular intervals.

If after a repeat assessment within approximately 3 weeks, the LVEF has not improved, has declined further, and/or the patient is symptomatic, permanently discontinue the fixed combination of pertuzumab, trastuzumab, and hyaluronidase-zzxf.

Following completion of the fixed combination of pertuzumab, trastuzumab, and hyaluronidase-zzxf, continue to monitor for cardiomyopathy and assess LVEF measurements every 6 months for at least 2 years as a component of adjuvant therapy.

Embryo-fetal Toxicity

The fixed combination of pertuzumab, trastuzumab, and hyaluronidase-zzxf can cause fetal harm when administered to a pregnant woman. In post-marketing reports, use of intravenous trastuzumab during pregnancy resulted in cases of oligohydramnios and oligohydramnios sequence manifesting as pulmonary hypoplasia, skeletal abnormalities, and neonatal death. In an animal reproduction study, administration of intravenous pertuzumab to pregnant cynomolgus monkeys during the period of organogenesis resulted in oligohydramnios, delayed fetal kidney development, and embryo-fetal death at exposures 2.5 to 20 times the exposure in humans at the recommended dose, based on Cmax.

Verify the pregnancy status of females of reproductive potential prior to the initiation of the fixed combination of pertuzumab, trastuzumab, and hyaluronidase-zzxf. Advise pregnant women and females of reproductive potential that exposure to the fixed combination of pertuzumab, trastuzumab, and hyaluronidase-zzxf during pregnancy or within 7 months prior to conception can result in fetal harm. Advise females of reproductive potential to use effective contraception during treatment and for 7 months following the last dose of the fixed combination of pertuzumab, trastuzumab, and hyaluronidase-zzxf.

Pulmonary Toxicity

The fixed combination of pertuzumab, trastuzumab, and hyaluronidase-zzxf can cause serious and fatal pulmonary toxicity. These adverse reactions have been reported with intravenous trastuzumab. Pulmonary toxicity includes dyspnea, interstitial pneumonitis, pulmonary infiltrates, pleural effusions, non-cardiogenic pulmonary edema, pulmonary insufficiency and hypoxia, acute respiratory distress syndrome, and pulmonary fibrosis. Patients with symptomatic intrinsic lung disease or with extensive tumor involvement of the lungs, resulting in dyspnea at rest, appear to have more severe toxicity.

Exacerbation of Chemotherapy-induced Neutropenia

The fixed combination of pertuzumab, trastuzumab, and hyaluronidase-zzxf may exacerbate chemotherapy-induced neutropenia. In randomized controlled clinical trials with intravenous trastuzumab, Grade 3-4 neutropenia and febrile neutropenia were higher in patients receiving trastuzumab in combination with myelosuppressive chemotherapy as compared to those who received chemotherapy alone. The incidence of septic death was similar among patients who received trastuzumab and those who did not.

Hypersensitivity and Administration-related Reactions

Severe administration-related reactions (ARRs), including hypersensitivity, anaphylaxis, and events with fatal outcomes, have been associated with IV pertuzumab and trastuzumab. Patients experiencing dyspnea at rest due to complications of advanced malignancy and comorbidities may be at increased risk of a severe or of a fatal ARR.

In the FeDeriCa study, the incidence of hypersensitivity was 1.2% in the fixed-combination pertuzumab, trastuzumab, and hyaluronidase-zzxf arm. Administration-related reactions occurred in 21% of patients who received the fixed combination of pertuzumab, trastuzumab, and hyaluronidase-zzxf. In the fixed-combination pertuzumab, trastuzumab, and hyaluronidase-zzxf arm, the most common administration-related reactions were injection site reaction (15%) and injection site pain (2%).

Closely monitor patients during and for 30 minutes after the injection of initial dose and during and for 15 minutes following subsequent injections of maintenance dose of the fixed combination of pertuzumab, trastuzumab, and hyaluronidase-zzxf. If a significant injection-related reaction occurs, slow down or pause the injection and administer appropriate medical therapies. Evaluate and carefully monitor patients until complete resolution of signs and symptoms.

Permanently discontinue with the fixed combination of pertuzumab, trastuzumab, and hyaluronidase-zzxf in patients who experience anaphylaxis or severe injection-related reactions. Medications to treat such reactions, as well as emergency equipment, should be available for immediate use. For patients experiencing reversible grade 1 or 2 hypersensitivity reactions, consider pre-medication with an analgesic, antipyretic, or an antihistamine prior to readministration of the fixed combination of pertuzumab, trastuzumab, and hyaluronidase-zzxf.

The fixed combination of pertuzumab, trastuzumab, and hyaluronidase-zzxf is contraindicated in patients with known hypersensitivity to pertuzumab, trastuzumab, hyaluronidase or to any of its excipients.

Specific Populations

Pregnancy

There is a pregnancy pharmacovigilance program for the fixed combination of pertuzumab, trastuzumab, and hyaluronidase-zzxf. If the fixed combination of pertuzumab, trastuzumab, and hyaluronidase-zzxf is administered during pregnancy, or if a patient becomes pregnant while receiving the drug or within 7 months following the last dose of the fixed combination of pertuzumab, trastuzumab, and hyaluronidase-zzxf, health care providers and patients should immediately report pertuzumab, trastuzumab, and hyaluronidase-zzxf exposure to Genentech at 1-888-835-2555.

Risk Summary: The fixed combination of pertuzumab, trastuzumab, and hyaluronidase-zzxf can cause fetal harm when administered to a pregnant woman. In post-marketing reports, use of IV trastuzumab during pregnancy resulted in cases of oligohydramnios and oligohydramnios sequence manifesting as pulmonary hypoplasia, skeletal abnormalities, and neonatal death. In an animal reproduction study, administration of pertuzumab to pregnant cynomolgus monkeys during the period of organogenesis resulted in oligohydramnios, delayed fetal kidney development, and embryo-fetal deaths at clinically relevant exposures that were 2.5 to 20-fold greater than exposures in humans receiving the recommended dose, based on Cmax . Apprise the patient of the potential risks to a fetus. There are clinical considerations if the fixed combination of pertuzumab, trastuzumab, and hyaluronidase-zzxf is used during pregnancy or within 7 months prior to conception.

The estimated background risk of major birth defects and miscarriage for the indicated population is unknown. In the U.S. general population, the estimated background risk of major birth defects and miscarriage in clinically recognized pregnancies is 2-4% and 15-20%, respectively.

Clinical Considerations: Monitor women who received the combination of pertuzumab, trastuzumab, and hyaluronidase-zzxf during pregnancy or within 7 months prior to conception for oligohydramnios. If oligohydramnios occurs, perform fetal testing that is appropriate for gestational age and consistent with community standards of care.

Human Data: In post-marketing reports, use of trastuzumab during pregnancy resulted in cases of oligohydramnios and of oligohydramnios sequence, manifesting in the fetus as pulmonary hypoplasia, skeletal abnormalities, and neonatal death. These case reports described oligohydramnios in pregnant women who received trastuzumab either alone or in combination with chemotherapy. In some case reports, amniotic fluid index increased after trastuzumab was stopped. In one case, trastuzumab therapy resumed after amniotic index improved and oligohydramnios recurred.

Animal Data: The fixed combination of pertuzumab, trastuzumab, and hyaluronidase-zzxf for subcutaneous injection contains pertuzumab, trastuzumab, and hyaluronidase.

Pertuzumab: Pregnant cynomolgus monkeys were treated on gestational day (GD) 19 with loading doses of 30 to 150 mg/kg pertuzumab, followed by bi-weekly doses of 10 to 100 mg/kg. These dose levels resulted in clinically relevant exposures of 2.5 to 20-fold greater than exposures in humans receiving the recommended dose, based on Cmax. Intravenous administration of pertuzumab from GD19 through GD50 (period of organogenesis) was embryotoxic, with dose-dependent increases in embryo-fetal death between GD25 to GD70. The incidences of embryo-fetal loss were 33, 50, and 85%. At Caesarean section on GD100, oligohydramnios, decreased relative lung and kidney weights, and microscopic evidence of renal hypoplasia consistent with delayed renal development were identified in all pertuzumab dose groups. Pertuzumab exposure was reported in offspring from all treated groups, at levels of 29% to 40% of maternal serum levels at GD100.

Trastuzumab: In studies where IV trastuzumab was administered to pregnant cynomolgus monkeys during the period of organogenesis at doses up to 25 mg/kg given twice weekly (up to 25 times the recommended weekly human dose of 2 mg/kg), trastuzumab crossed the placental barrier during the early (GD 20 to 50) and late (GD 120 to 150) phases of gestation. The resulting concentrations of trastuzumab in fetal serum and amniotic fluid were approximately 33% and 25%, respectively, of those present in the maternal serum but were not associated with adverse developmental effects.

Hyaluronidase: In an embryo-fetal study, mice have been dosed daily by subcutaneous injection during the period of organogenesis with hyaluronidase (recombinant human) at dose levels up to 2,200,000 U/kg, which is >2,400 and 3,600, based on loading and maintenance doses, respectively, times higher than the human dose. The study found no evidence of teratogenicity. Reduced fetal weight and increased numbers of fetal resorptions were observed, with no effects found at a daily dose of 360,000 U/kg, which is >400 and 600, based on loading and maintenance doses, respectively, times higher than the human dose.

In a peri-and post-natal reproduction study, mice have been dosed daily by subcutaneous injection, with hyaluronidase (recombinant human) from implantation through lactation and weaning at dose levels up to 1,100,000 U/kg, which is >1,200 and 1,800, based on loading and maintenance doses, respectively, times higher than the human dose. The study found no adverse effects on sexual maturation, learning and memory or fertility of the offspring.

Lactation

Risk Summary: There is no information regarding the presence of pertuzumab, trastuzumab or hyaluronidase in human milk, the effects on the breastfed infant, or the effects on milk production. Published data suggest that human IgG is present in human milk but does not enter the neonatal and infant circulation in substantial amounts. Trastuzumab was present in the milk of lactating cynomolgus monkeys but not associated with neonatal toxicity. Consider the developmental and health benefits of breast feeding along with the mother's clinical need for the fixed combination of pertuzumab, trastuzumab, and hyaluronidase-zzxf treatment and any potential adverse effects on the breastfed child from the fixed combination of pertuzumab, trastuzumab, and hyaluronidase-zzxf or from the underlying maternal condition. This consideration should also take into account the elimination half-life of pertuzumab and the trastuzumab wash out period of 7 months.

Data: In lactating cynomolgus monkeys, trastuzumab was present in breast milk at about 0.3% of maternal serum concentrations after pre- (beginning GD 120) and post-partum (through post-partum day 28) doses of 25 mg/kg administered twice weekly (25 times the recommended weekly human dose of 2 mg/kg of IV trastuzumab). Infant monkeys with detectable serum levels of trastuzumab did not exhibit any adverse effects on growth or development from birth to 1 month of age.

Females and Males of Reproductive Potential

The fixed combination of pertuzumab, trastuzumab, and hyaluronidase-zzxf can cause embryo-fetal harm when administered during pregnancy.

Verify the pregnancy status of females of reproductive potential prior to the initiation of the fixed combination of pertuzumab, trastuzumab, and hyaluronidase-zzxf.

Advise females of reproductive potential to use effective contraception during treatment and for 7 months following the last dose of the fixed combination of pertuzumab, trastuzumab, and hyaluronidase-zzxf.

Pediatric Use

The safety and effectiveness of the fixed combination of pertuzumab, trastuzumab, and hyaluronidase-zzxf in pediatric patients have not been established.

Geriatric Use

Of the total number of patients in the FeDeriCa study (n=500) treated with the fixed combination of pertuzumab, trastuzumab, and hyaluronidase-zzxf, 11% were 65 and over, while 1.6% were 75 and over. Clinical studies of the fixed combination of pertuzumab, trastuzumab, and hyaluronidase-zzxf did not include sufficient numbers of patients age 65 years and older to determine whether they respond differently from younger patients.

In the IV trastuzumab trials, the risk of cardiac dysfunction was increased in geriatric patients as compared to younger patients, in both those receiving treatment for adjuvant therapy or metastatic disease. Other differences in safety or effectiveness were not observed between elderly patients and younger patients. In the IV pertuzumab in combination with trastuzumab trials, the risk of decreased appetite, anemia, weight decreased, asthenia, dysgeusia, neuropathy peripheral and hypomagnesemia was increased in patients 65 years of age and older compared to patients less than 65 years of age.

Common Adverse Effects

Neoadjuvant and adjuvant treatment of breast cancer: Most common adverse reactions (>30%) with the fixed combination of pertuzumab, trastuzumab, and hyaluronidase-zzxf were alopecia, nausea, diarrhea, anemia, and asthenia.

Metastatic breast cancer (based on IV pertuzumab): Most common adverse reactions (>30%) with pertuzumab in combination with trastuzumab and docetaxel were diarrhea, alopecia, neutropenia, nausea, fatigue, rash, and peripheral neuropathy.

Drug Interactions

Specific Drugs

It is essential that the manufacturer's labeling be consulted for more detailed information on interactions with this drug, including possible dosage adjustments. Interaction highlights:

Patients who receive anthracycline after stopping the fixed combination of pertuzumab, trastuzumab, and hyaluronidase-zzxf may be at increased risk of cardiac dysfunction because of the fixed combination of pertuzumab, trastuzumab, and hyaluronidase-zzxf's long washout period. If possible, avoid anthracycline-based therapy for up to 7 months after stopping the fixed combination of pertuzumab, trastuzumab, and hyaluronidase-zzxf. If anthracyclines are used, carefully monitor the patient's cardiac function.

Actions

Mechanism of Action

Pertuzumab targets the extracellular dimerization domain (subdomain II) of HER2 and, thereby, blocks ligand-dependent heterodimerization of HER2 with other HER family members, including EGFR, HER3 and HER4. As a result, pertuzumab inhibits ligand-initiated intracellular signaling through two major signaling pathways, mitogen-activated protein (MAP) kinase and phosphoinositide 3-kinase (PI3K). Inhibition of these signaling pathways can result in cell growth arrest and apoptosis, respectively.

Trastuzumab binds to subdomain IV of the extracellular domain of the HER2 protein to inhibit the ligand-independent, HER2 mediated cell proliferation and PI3K signaling pathway in human tumor cells that overexpress HER2.

Both pertuzumab and trastuzumab-mediated antibody-dependent cell-mediated cytotoxicity (ADCC) have been shown to be preferentially exerted on HER2 overexpressing cancer cells compared with cancer cells that do not overexpress HER2.

While pertuzumab alone inhibited the proliferation of human tumor cells, the combination of pertuzumab and trastuzumab augmented anti-tumor activity in HER2-overexpressing xenograft models.

Hyaluronan is a polysaccharide found in the extracellular matrix of the subcutaneous tissue. It is depolymerized by the naturally occurring enzyme hyaluronidase. Unlike the stable structural components of the interstitial matrix, hyaluronan has a half-life of approximately 0.5 days. Hyaluronidase increases permeability of the subcutaneous tissue by depolymerizing hyaluronan. In the doses administered, hyaluronidase in the fixed combination of pertuzumab, trastuzumab, and hyaluronidase-zzxf acts transiently and locally.

The effects of hyaluronidase are reversible and permeability of the subcutaneous tissue is restored within 24 to 48 hours.

Hyaluronidase has been shown to increase the absorption rate of a trastuzumab product into the systemic circulation when given in the subcutis of Göttingen Minipigs.

Advice to Patients

Cardiomyopathy

Advise patients to contact a health care professional immediately for any of the following: new onset or worsening shortness of breath, cough, swelling of the ankles/legs, swelling of the face, palpitations, weight gain of more than 5 pounds in 24 hours, dizziness or loss of consciousness.

Embryo-Fetal Toxicity

Advise pregnant women and females of reproductive potential that exposure to the fixed combination of pertuzumab, trastuzumab, and hyaluronidase-zzxf during pregnancy or within 7 months prior to conception can result in fetal harm. Advise female patients to contact their healthcare provider with a known or suspected pregnancy.

Advise women who are exposed to the fixed combination of pertuzumab, trastuzumab, and hyaluronidase-zzxf during pregnancy or within 7 months prior to conception that there is a pregnancy pharmacovigilance program that monitors pregnancy outcomes. Encourage these patients to report their pregnancy to Genentech.

Advise females of reproductive potential to use effective contraception during treatment and for 7 months following the last dose of the fixed combination of pertuzumab, trastuzumab, and hyaluronidase-zzxf.

Hypersensitivity and Administration-Related Reactions

Advise patients to contact their healthcare provider immediately and to report any symptoms of hypersensitivity and administration-related reactions including dizziness, nausea, chills, fever, vomiting, diarrhea, urticaria, angioedema, breathing problems, or chest pain.

Additional Information

AHFSfirstRelease. For additional information until a more detailed monograph is developed and published, the manufacturer's labeling should be consulted. It is essential that the manufacturer's labeling be consulted for more detailed information on usual uses, dosage and administration, cautions, precautions, contraindications, potential drug interactions, laboratory test interferences, and acute toxicity.

Preparations

Excipients in commercially available drug preparations may have clinically important effects in some individuals; consult specific product labeling for details.

Please refer to the ASHP Drug Shortages Resource Center for information on shortages of one or more of these preparations.

Pertuzumab, Trastuzumab, and Hyaluronidase-zzxf

Routes

Dosage Forms

Strengths

Brand Names

Manufacturer

Parenteral

Injection, for subcutaneous use

80 mg/mL pertuzumab (1200 mg), 40 mg/mL trastuzumab (600 mg), 2000 units/mL hyaluronidase (30,000 units)

Phesgo

Genentech.

60 mg/mL pertuzumab (600 mg), 60 mg/mL trastuzumab (600 mg), 2000 units/mL hyaluronidase (20,000 units)

Phesgo

Genentech.

AHFS Drug Information. © Copyright 2021, Selected Revisions August 3, 2020. American Society of Health-System Pharmacists, Inc., 4500 East-West Highway, Suite 900, Bethesda, Maryland 20814.

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