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Systemic Anti-Cancer Therapy Regimen Library

Home > BR Metastatic - PACLItaxel Q1W and pERTUZumab/trastuzumab subcutaneous Q3W [Phesgo]

BR Metastatic - PACLItaxel Q1W and pERTUZumab/trastuzumab subcutaneous Q3W [Phesgo]

Treatment Overview

Subcutaneous pERTUZumab + trastuzumab [Phesgo®] may continue after paclitaxel has been discontinued until disease progression or unacceptable toxicity.

Cycle 1 - 21 days - PACLItaxel Q1W (tapering pre-medications) and pERTUZumab/trastuzumab [Phesgo®] Loading Dose

Cycle length:
21

pertuzumab + trastuzumab [Phesgo®] is for subcutaneous use only. Do not administer intravenously.


paclitaxel: Tapering schedule of pre-medications is for patients who did not experience a hypersensitivity reaction to the previous dose of weekly paclitaxel.

Cycle 2 (and all further cycles) - 21 days - PACLItaxel Q1W (no pre-medications) and pERTUZumab/trastuzumab [Phesgo®] Maintenance Dose

Cycle length:
21

pertuzumab + trastuzumab [Phesgo®] is for subcutaneous use only. Do not administer intravenously. 


paclitaxel: Tapering schedule of pre-medications is for patients who did not experience a hypersensitivity reaction to the previous dose of weekly paclitaxel.

Cycle details

Cycle 1 - 21 days - PACLItaxel Q1W (tapering pre-medications) and pERTUZumab/trastuzumab [Phesgo®] Loading Dose

Medication Dose Route Days Max Duration
dexamethasone * 8 mg oral administration 1
dexamethasone * 4 mg oral administration 8
loratadine * 10 mg oral administration 1, 8, 15
ondansetron 8 mg oral administration 15
pERTUZumab 1.2 g + trastuzumab 600 mg injection * 1 Vial subcutaneous injection 1 8 minutes
PACLItaxel * 80 mg/m² intravenous 1, 8, 15 60 minutes
domperidone 10 mg Three times daily oral administration 1

pertuzumab + trastuzumab [Phesgo®] is for subcutaneous use only. Do not administer intravenously.


paclitaxel: Tapering schedule of pre-medications is for patients who did not experience a hypersensitivity reaction to the previous dose of weekly paclitaxel.

Cycle 2 (and all further cycles) - 21 days - PACLItaxel Q1W (no pre-medications) and pERTUZumab/trastuzumab [Phesgo®] Maintenance Dose

Medication Dose Route Days Max Duration
ondansetron 8 mg oral administration 1, 8, 15
pERTUZumab 600 mg + trastuzumab 600 mg injection * 1 Vial subcutaneous injection 1 5 minutes
PACLItaxel * 80 mg/m² intravenous 1, 8, 15 60 minutes
domperidone 10 mg Three times daily oral administration 1

pertuzumab + trastuzumab [Phesgo®] is for subcutaneous use only. Do not administer intravenously. 


paclitaxel: Tapering schedule of pre-medications is for patients who did not experience a hypersensitivity reaction to the previous dose of weekly paclitaxel.

Full details

Cycle 1 - 21 days - PACLItaxel Q1W (tapering pre-medications) and pERTUZumab/trastuzumab [Phesgo®] Loading Dose

Day: 1

Medication Dose Route Max duration Details
dexamethasone * 8 mg oral administration
Instructions:

ONE hour prior to paclitaxel infusion with food.
loratadine * 10 mg oral administration
Instructions:

ONE hour prior to paclitaxel infusion.

pERTUZumab 1.2 g + trastuzumab 600 mg injection * 1 Vial subcutaneous injection 8 minutes
Instructions:
  • Phesgo® [pertuzumab + trastuzumab] is for subcutaneous use only. Do not administer intravenously.
  • An observation period of 30 minutes post-administration is recommended prior to administration of further systemic anti-cancer treatment.
PACLItaxel * 80 mg/m² intravenous 60 minutes
Instructions:
  • Prepare solution in PVC-free bag and administer via polyethylene lined administration set with an in-line filter of 0.22 microns or less in size.
  • Please carry out graded challenge as per institutional policy.
domperidone 10 mg Three times daily oral administration
Instructions:

When required for nausea and/or vomiting.

  • The choice of rescue antiemetic may be substituted to reflect institutional policy or individual patient characteristics.

Day: 8

Medication Dose Route Max duration Details
dexamethasone * 4 mg oral administration
Instructions:

ONE hour prior to paclitaxel infusion with food.
loratadine * 10 mg oral administration
Instructions:

ONE hour prior to paclitaxel infusion.

PACLItaxel * 80 mg/m² intravenous 60 minutes
Instructions:
  • Prepare solution in PVC-free bag and administer via polyethylene lined administration set with an in-line filter of 0.22 microns or less in size.
  • Please carry out graded challenge as per institutional policy.

Day: 15

Medication Dose Route Max duration Details
loratadine * 10 mg oral administration
Instructions:

ONE hour prior to paclitaxel infusion.

ondansetron 8 mg oral administration
Instructions:

ONE hour prior to chemotherapy.

  • Alternative is dexamethasone 4 mg.
PACLItaxel * 80 mg/m² intravenous 60 minutes
Instructions:
  • Prepare solution in PVC-free bag and administer via polyethylene lined administration set with an in-line filter of 0.22 microns or less in size.
  • Please carry out graded challenge as per institutional policy.

Cycle 2 (and all further cycles) - 21 days - PACLItaxel Q1W (no pre-medications) and pERTUZumab/trastuzumab [Phesgo®] Maintenance Dose

Day: 1

Medication Dose Route Max duration Details
ondansetron 8 mg oral administration
Instructions:

ONE hour prior to chemotherapy.

  • Alternative is dexamethasone 4 mg.
pERTUZumab 600 mg + trastuzumab 600 mg injection * 1 Vial subcutaneous injection 5 minutes
Instructions:
  • Phesgo® [pertuzumab + trastuzumab] is for subcutaneous use only. Do not administer intravenously.
  • An observation period of 15 minutes post-administration is recommended prior to administration of further systemic anti-cancer treatment.
PACLItaxel * 80 mg/m² intravenous 60 minutes
Instructions:
  • Prepare solution in PVC-free bag and administer via polyethylene lined administration set with an in-line filter of 0.22 microns or less in size.
  • Please carry out graded challenge as per institutional policy.
domperidone 10 mg Three times daily oral administration
Instructions:

When required for nausea and/or vomiting.

  • The choice of rescue antiemetic may be substituted to reflect institutional policy or individual patient characteristics.

Day: 8

Medication Dose Route Max duration Details
ondansetron 8 mg oral administration
Instructions:

ONE hour prior to chemotherapy.

  • Alternative is dexamethasone 4 mg.
PACLItaxel * 80 mg/m² intravenous 60 minutes
Instructions:
  • Prepare solution in PVC-free bag and administer via polyethylene lined administration set with an in-line filter of 0.22 microns or less in size.
  • Please carry out graded challenge as per institutional policy.

Day: 15

Medication Dose Route Max duration Details
ondansetron 8 mg oral administration
Instructions:

ONE hour prior to chemotherapy.

  • Alternative is dexamethasone 4 mg.
PACLItaxel * 80 mg/m² intravenous 60 minutes
Instructions:
  • Prepare solution in PVC-free bag and administer via polyethylene lined administration set with an in-line filter of 0.22 microns or less in size.
  • Please carry out graded challenge as per institutional policy.

Supportive Care Factors

Factor Value
Emetogenicity: Low
Hypersensitivity / Infusion related reaction risk: High - routine premedication recommended

References

Dang C, Iyengar N, Datko F, et al. Phase II study of paclitaxel given once per week along with trastuzumab and pertuzumab in patients with human epidermal growth factor receptor 2-positive metastatic breast cancer. J Clin Oncol. 2015 Feb 10;33(5):442-7. Erratum in: J Clin Oncol. 2019 Feb 1;37(4):354., PMID: 25547504

Baselga J, Cortés J, Kim SB, et al; CLEOPATRA Study Group. Pertuzumab plus trastuzumab plus docetaxel for metastatic breast cancer. N Engl J Med. 2012 Jan 12;366(2):109-19., PMID: 22149875

Bachelot T, Ciruelos T, Peretz-Yablonski, et al. First-line pertuzumab (P), trastuzumab (H), and taxane therapy for HER2-positive locally recurrent/metastatic breast cancer (LR/mBC): Interim safety results (N=704) from PERUSE. ASCO Meeting Abstracts. 2014 32(15_suppl):548.

Tan AR, Im SA, Mattar A, et al; FeDeriCa study group. Fixed-dose combination of pertuzumab and trastuzumab for subcutaneous injection plus chemotherapy in HER2-positive early breast cancer (FeDeriCa): a randomised, open-label, multicentre, non-inferiority, phase 3 study. Lancet Oncol. 2021 Jan;22(1):85-97. Epub 2020 Dec 21. Erratum in: Lancet Oncol. 2021 Feb;22(2):e42., PMID: 33357420

Novartis New Zealand Ltd. Paclitaxel Ebewe New Zealand Data Sheet 16 April 2020. https://www.medsafe.govt.nz/profs/Datasheet/p/PaclitaxelEbeweinj.pdf (Accessed 26 November 2020)

Roche Products (New Zealand) Limited. Phesgo New Zealand Data Sheet 22 September 2022. https://www.medsafe.govt.nz/profs/Datasheet/p/Phesgoinj.pdf (Accessed 7 November 2025)

Boulanger J, Boursiquot JN, Cournoyer G, et al. Management of hypersensitivity to platinum- and taxane-based chemotherapy: cepo review and clinical recommendations. Curr Oncol. 2014;21(4):e630-e641., PMID: 25089112

* The medicines, doses, combinations, and schedule in this treatment regimen have been carefully reviewed against international best practice guidelines by specialists in medical oncology around New Zealand and this advice has been accepted for publication by Te Aho o Te Kahu (the Cancer Control Agency). Sometimes medicines that are used in routine clinical practice have not been through a formal review process by the NZ Medicines Regulator Medsafe and are therefore considered unapproved or off-label. These medicines are legally able to be prescribed through sections 25 and 29 of the Medicines Act and by obtaining informed consent from patients. All treatment regimens listed on this website have been through robust peer review and are considered an accepted standard of care, whether prescribed through sections 25 or 29 or carrying formal Medsafe Approval.

s29: This symbol indicates that some formulations of the associated medicine are legally only able to be prescribed under section 29 of the Medicines Act. You can see which formulations are section 29 by hovering over the s29 symbol. You can access full medication details from the New Zealand Formulary by clicking on the medication name. Each clinician retains full responsibility for ensuring they have complied with all relevant obligations and requirements of section 29 including obtaining informed patient consent prior to prescribing the applicable medicine.