THP: Taxotere, Herceptin, and pertuzumab

THP (docetaxel, trastuzumab, and pertuzumab) is a chemotherapy regimen used to treat HER2-positive breast cancer. It contains these medicines:

• Docetaxel (Taxotere) – a type of chemotherapy medicine called a taxane
• Trastuzumab (Herceptin) – a type of targeted therapy called a monoclonal antibody
• Pertuzumab (Perjeta) – a type of monoclonal antibody

How THP works

Docetaxel works by damaging the structure or the “skeleton” that supports cancer cells. This stops the cancer cells from growing and dividing.

Trastuzumab attaches to HER2 proteins on the surface of HER2-positive cancer cells and blocks the signals that cause cancer cells to multiply. After attaching to cancer cells, it can also alert the immune system to kill them.

Pertuzumab attaches to HER2 proteins on the surface of HER2-positive cancer cells and blocks the signals that cause cancer cells to multiply. It attaches to the HER2 protein in a different way from trastuzumab, so the two medicines work together well. After attaching to cancer cells, it can also alert the immune system to kill them.

Who gets THP

THP is used as neoadjuvant therapy, before surgery, to treat HER2-positive breast cancers with:

• A large tumor in the breast, or that have traveled to nearby lymph nodes, or
• An inflammatory tumor, which causes the breast to look red and swollen and feel warm to the touch

THP is also used to treat metastatic HER2-positive breast cancer.

You and your doctor will discuss the best chemotherapy treatment for your situation.

How THP is given

THP is given by vein. When given as neoadjuvant treatment before surgery, THP is usually given four times, once every 3 weeks. After surgery, you will receive trastuzumab either weekly or once every 3 weeks for a total of a year. You may receive other chemotherapy as well.

For metastatic disease, THP is usually given once every 3 weeks. It may be given as long as it controls the disease and side effects do not disrupt your quality of life.

If your doctor recommends you stop docetaxel due to side effects, you may still be able to continue treatment with pertuzumab and trastuzumab.

Side effects and things to remember

Different medicines have different side effects. You may not have every side effect related to each medicine of the combination therapy.

Side effects of THP may include:

• Decrease of white blood cells, red blood cells and platelets
• Neuropathy, numbness and tingling in the hands or feet
• Diarrhea
• Fatigue
• Hair loss
• Joint or muscle pain
• Mouth sores
• Nail and skin changes
• Nausea

Heart problems are a rare but serious side effect of trastuzumab. These include congestive heart failure, when the heart muscle weakens and doesn’t pump blood well. Your doctor will check your heart before you start treatment and every several months during treatment. Be sure to tell your doctor if you have ever had heart problems.

Tell your doctor about any medicines you are taking, including vitamins, herbal supplements, and over-the counter-medicines, to make sure they will not interfere with your chemotherapy treatment.

Contact your doctor right away if you develop a fever or other symptoms of an infection such as a sore throat or chills.

Talk to your doctor, pharmacist or nurse about all your side effects so that they can help you manage them. You can also go to our section on Side Effects for more information.