| HER2-positive carcinoma of breast
Margenza vs Phesgo
Side-by-side clinical, coverage, and cost comparison for her2-positive carcinoma of breast.Deep comparison between: Margenza vs Phesgo with Prescriber.AI
AI compares prescribing info and payer-specific access barriers across 1,200+ formularies. Here's a preview of what prescribers are already asking.Safety signalsPhesgo has a higher rate of injection site reactions vs Margenza based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Phesgo but not Margenza, including UnitedHealthcare
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Category
Margenza
Phesgo
At A Glance
IV infusion
Every 3 weeks
HER2/neu receptor antagonist
SC injection
Every 3 weeks
HER2/neu receptor antagonist
Indications
- HER2-positive carcinoma of breast
- HER2-positive carcinoma of breast
- Inflammatory Breast Carcinoma
- Locally advanced breast cancer
- Carcinoma breast stage IV
Dosing
HER2-positive carcinoma of breast 15 mg/kg IV infusion every 3 weeks (21-day cycle) until disease progression or unacceptable toxicity; initial dose over 120 minutes, subsequent doses over a minimum of 30 minutes.
HER2-positive carcinoma of breast, Inflammatory Breast Carcinoma, Locally advanced breast cancer Initial dose 1,200 mg pertuzumab / 600 mg trastuzumab / 30,000 units hyaluronidase SC over ~8 min, then maintenance 600 mg pertuzumab / 600 mg trastuzumab / 20,000 units hyaluronidase SC over ~5 min every 3 weeks with chemotherapy; neoadjuvant: 3-6 preoperative cycles then continue to complete 18 total cycles; adjuvant: up to 18 cycles (1 year) starting Day 1 of first taxane-containing cycle.
Carcinoma breast stage IV Initial dose 1,200 mg pertuzumab / 600 mg trastuzumab / 30,000 units hyaluronidase SC over ~8 min, then maintenance 600 mg pertuzumab / 600 mg trastuzumab / 20,000 units hyaluronidase SC over ~5 min every 3 weeks with docetaxel until disease progression or unmanageable toxicity.
Contraindications
—
- Known hypersensitivity to pertuzumab, trastuzumab, hyaluronidase, or any excipient of PHESGO
Adverse Reactions
Most common (>10%) Fatigue/asthenia, nausea, diarrhea, vomiting, constipation, abdominal pain, pyrexia, headache, alopecia, peripheral neuropathy, decreased appetite, cough, arthralgia/myalgia, dyspnea, infusion-related reaction, palmar-plantar erythrodysesthesia, extremity pain
Serious Febrile neutropenia, neutropenia/neutrophil count decrease, infusion-related reactions, left ventricular dysfunction
Most common (>=5%) Alopecia, nausea, diarrhea, anemia, asthenia, fatigue, stomatitis, myalgia, arthralgia, neutropenia, vomiting, constipation, headache, dysgeusia, decreased appetite, peripheral sensory neuropathy, mucosal inflammation, injection site reaction, radiation skin injury, insomnia, cough
Serious Febrile neutropenia, neutropenic sepsis, neutrophil count decreased, cardiomyopathy, pulmonary toxicity
Postmarketing Glomerulopathy, immune thrombocytopenia, tumor lysis syndrome
Pharmacology
HER2/neu receptor antagonist; chimeric Fc-engineered IgG1 kappa monoclonal antibody that binds to the HER2 extracellular domain, inhibits tumor cell proliferation, reduces HER2 shedding, and mediates ADCC via enhanced binding to activating Fc receptor FCGR3A and decreased binding to inhibitory FCGR2B.
Pertuzumab blocks HER2 heterodimerization at subdomain II to inhibit MAP kinase and PI3K signaling, trastuzumab binds subdomain IV to inhibit HER2-mediated cell proliferation, and together they augment antibody-dependent cell-mediated cytotoxicity against HER2-overexpressing tumor cells; hyaluronidase transiently depolymerizes hyaluronan to increase subcutaneous tissue permeability and enable systemic absorption.
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Most Common Insurance
Anthem BCBS
Margenza
- Covered on 5 commercial plans
- PA (10/12) · Step Therapy (0/12) · Qty limit (0/12)
Phesgo
- Covered on 5 commercial plans
- PA (12/12) · Step Therapy (0/12) · Qty limit (0/12)
UnitedHealthcare
Margenza
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (0/8)
Phesgo
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (0/8)
Humana
Margenza
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (0/3) · Qty limit (0/3)
Phesgo
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (0/3) · Qty limit (2/3)
Coverage data sourced from MMIT. Updated monthly.
Savings
Cost estimate not availableAssistance Fund: Breast Cancer
Commercial or private insurance
Medicare, Medicaid, VA, TRICARE
Cost estimate not availableAssistance Fund: Breast Cancer
Commercial or private insurance
Medicare, Medicaid, VA, TRICARE
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.