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Systemic Anti-Cancer Therapy Regimen Library

Home > BR Metastatic - DOCEtaxel and pERTUZumab/trastuzumab subcutaneous [Phesgo]

BR Metastatic - DOCEtaxel and pERTUZumab/trastuzumab subcutaneous [Phesgo]

Treatment Overview

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

Cycle 1 - 21 days - pERTUZumab/trastuzumab [Phesgo®] Loading Dose

Cycle length:
21

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


docetaxel: Some centres may wish to replace the three oral doses of dexamethasone 8 mg premedication with a single intravenous dose of dexamethasone 20 mg prior to docetaxel infusion.

Cycle 2 (and all further cycles) - 21 days - pERTUZumab/trastuzumab [Phesgo®] Maintenance Dose

Cycle length:
21

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


docetaxel: Some centres may wish to replace the three oral doses of dexamethasone 8 mg premedication with a single intravenous dose of dexamethasone 20 mg prior to docetaxel infusion.

Cycle details

Cycle 1 - 21 days - pERTUZumab/trastuzumab [Phesgo®] Loading Dose

Medication Dose Route Days Max Duration
dexamethasone * 8 mg Twice daily oral administration 0, 1, 2
pERTUZumab 1.2 g + trastuzumab 600 mg injection 1 Vial subcutaneous injection 1 8 minutes
DOCEtaxel * 75 mg/m² intravenous 1 60 minutes
domperidone 10 mg Three times daily oral administration 1
loperamide 2 mg oral administration 1

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


docetaxel: Some centres may wish to replace the three oral doses of dexamethasone 8 mg premedication with a single intravenous dose of dexamethasone 20 mg prior to docetaxel infusion.

Cycle 2 (and all further cycles) - 21 days - pERTUZumab/trastuzumab [Phesgo®] Maintenance Dose

Medication Dose Route Days Max Duration
dexamethasone * 8 mg Twice daily oral administration 0, 1, 2
pERTUZumab 600 mg + trastuzumab 600 mg injection 1 Vial subcutaneous injection 1 5 minutes
DOCEtaxel * 75 mg/m² intravenous 1 60 minutes
domperidone 10 mg Three times daily oral administration 1
loperamide 2 mg oral administration 1

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


docetaxel: Some centres may wish to replace the three oral doses of dexamethasone 8 mg premedication with a single intravenous dose of dexamethasone 20 mg prior to docetaxel infusion.

Full details

Cycle 1 - 21 days - pERTUZumab/trastuzumab [Phesgo®] Loading Dose

Day: 0

Medication Dose Route Max duration Details
dexamethasone * 8 mg Twice daily oral administration
Instructions:
Take with food.

Day: 1

Medication Dose Route Max duration Details
dexamethasone * 8 mg Twice daily oral administration
Instructions:
Take with food.
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.
DOCEtaxel * 75 mg/m² intravenous 60 minutes
Instructions:
  • Prepare solution in PVC-free bag and administer via polyethylene lined administration set.
  • 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.
loperamide 2 mg oral administration
Instructions:
Take TWO capsules (=4 mg) at onset of loose bowel motions and a further ONE capsule (=2 mg) for every loose bowel motion (maximum of EIGHT capsules in 24 hours), or use as directed by oncologist or haematologist.

Day: 2

Medication Dose Route Max duration Details
dexamethasone * 8 mg Twice daily oral administration
Instructions:
Take with food.

Cycle 2 (and all further cycles) - 21 days - pERTUZumab/trastuzumab [Phesgo®] Maintenance Dose

Day: 0

Medication Dose Route Max duration Details
dexamethasone * 8 mg Twice daily oral administration
Instructions:
Take with food.

Day: 1

Medication Dose Route Max duration Details
dexamethasone * 8 mg Twice daily oral administration
Instructions:
Take with food.
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.
DOCEtaxel * 75 mg/m² intravenous 60 minutes
Instructions:
  • Prepare solution in PVC-free bag and administer via polyethylene lined administration set.
  • 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.
loperamide 2 mg oral administration
Instructions:
Take TWO capsules (=4 mg) at onset of loose bowel motions and a further ONE capsule (=2 mg) for every loose bowel motion (maximum of EIGHT capsules in 24 hours), or use as directed by oncologist or haematologist.

Day: 2

Medication Dose Route Max duration Details
dexamethasone * 8 mg Twice daily oral administration
Instructions:
Take with food.

Supportive Care Factors

Factor Value
Diarrhoea risk: Anti-diarrhoeals are usually prescribed with this treatment
Emetogenicity: Low
Hypersensitivity / Infusion related reaction risk: High - routine premedication recommended

References

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

Swain SM, Baselga J, Kim SB, et al; CLEOPATRA Study Group. Pertuzumab, trastuzumab, and docetaxel in HER2-positive metastatic breast cancer. N Engl J Med. 2015 Feb 19;372(8):724-34., PMID: 25693012

Swain SM, Baselga J, Miles D, et al. Incidence of central nervous system metastases in patients with HER2-positive metastatic breast cancer treated with pertuzumab, trastuzumab, and docetaxel: results from the randomized phase III study CLEOPATRA. Ann Oncol. 2014 Jun;25(6):1116-21., PMID: 24685829

Swain SM, Kim SB, Cortés J, et al. Pertuzumab, trastuzumab, and docetaxel for HER2-positive metastatic breast cancer (CLEOPATRA study): overall survival results from a randomised, double-blind, placebo-controlled, phase 3 study. Lancet Oncol. 2013 May;14(6):461-71., PMID: 23602601

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

Pfizer New Zealand Limited. DBL Docetaxel New Zealand Data Sheet 07 August 2020. https://www.medsafe.govt.nz/profs/Datasheet/d/dbldocetaxelinj.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)

Chouhan JD, Herrington JD. Single premedication dose of dexamethasone 20 mg IV before docetaxel administration. J Oncol Pharm Pract. 2011 Sep;17(3):155-9. doi: 10.1177/1078155210367950. Epub 2010 May 6., PMID: 20447949

Rogers, E. S., E. Witton, J. Stewart, and D. Porter. Efficacy and safety of a single dose of dexamethasone pre docetaxel treatment: The Auckland experience. Annals of Oncology 25 (2014): iv537.

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.