Name of the Procedure:

Injection, pertuzumab, trastuzumab, and hyaluronidase-zzxf, per 10 mg
Common names: HER2-targeted therapy injection
Technical term: Subcutaneous injection of pertuzumab, trastuzumab, and hyaluronidase-zzxf (J9316)

Summary

This procedure involves a subcutaneous injection of a combination of drugs—pertuzumab, trastuzumab, and hyaluronidase-zzxf. These medications are typically used in the treatment of HER2-positive breast cancer to inhibit cancer cell growth and proliferation.

Purpose

This injection is primarily used to treat HER2-positive breast cancer. The goals are to slow or stop the growth of cancer cells, shrink tumors before surgery, reduce the risk of cancer recurrence, or manage symptoms of advanced cancer.

Indications

• Diagnosed HER2-positive breast cancer
• Tumors that overexpress the HER2 protein
• Patients requiring neoadjuvant or adjuvant therapy
• Recurrence of HER2-positive breast cancer

Preparation

• No specific fasting required.
• Avoid certain medications as advised by the healthcare provider to prevent interactions.
• Blood tests and imaging studies may be needed to assess overall health and therapy effectiveness.
• An allergy test to determine any hypersensitivity to the medication components.

Procedure Description

1. The patient is positioned comfortably, usually in a seated or reclining position.
2. The injection site is cleaned and sterilized, commonly the thigh or abdomen.
3. Using a fine needle, the combination of pertuzumab, trastuzumab, and hyaluronidase-zzxf is injected subcutaneously.
4. The process is monitored for immediate adverse reactions.

Tools and equipment: A syringe, needle, and antiseptic wipes. Anesthesia or sedation: Not typically required for this subcutaneous injection.

Duration

The injection process itself usually takes about 5 to 10 minutes. Including preparation and observation, the entire visit may take around an hour.

Setting

This procedure is performed in an outpatient clinic or a hospital's specialized oncology unit.

Personnel

• Oncologist or nurse practitioner administers the injection.
• Registered nurse may assist with preparation and post-procedure monitoring.

Risks and Complications

• Common: Pain at the injection site, redness, and swelling.
• Rare: Severe allergic reactions, cardiac issues, or respiratory difficulties.
• Management: Immediate medical intervention for severe allergic reactions; monitoring and supportive therapy for cardiac issues.

Benefits

• Slows or halts cancer growth.
• Reduces tumor size, facilitating surgical removal.
• Lowers the chance of cancer recurrence.
• Benefits may be observed within weeks to months, depending on individual response.

Recovery

• Minimal post-procedure downtime.
• Resume normal activities nearly immediately, although some patients might need an observation period.
• Follow-up appointments to monitor the response to treatment and manage any side effects.

Alternatives

• Intravenous administration of pertuzumab and trastuzumab.
• Other targeted therapies or chemotherapy.
• Pros: IV administration may be more controlled; other treatments may be necessary if patient exhibits intolerances.
• Cons: IV administration requires longer clinic visits; other therapies may have different side effects or efficiency levels.

Patient Experience

• Mild pain at the injection site during and shortly after the procedure.
• Monitoring and support for any discomfort or adverse effects.
• Comfort measures, such as cold packs, can be provided to minimize pain and swelling.