Perjeta after surgery for early-stage cancer?

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Anonymous
Anonymous Member Posts: 1,376
edited July 2014 in HER2+ (Positive) Breast Cancer

I got my six rounds before surgery. Onc says he doesn't think I'd be approved for more Perjeta after surgery due to some FDA regulation. Yet I have read about women on this message board and others getting Perjeta for a whoie year alongside Herceptin. I am confused but definitely want as much Perjeta as I can get. Any insight as to why others are approved for Perjeta but my onc thinks I wouldn't be. I'm Stage III and "high-risk" so I think I would be a perfect candidate.

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  • SpecialK
    SpecialK Member Posts: 16,486
    edited July 2014

    Technically Perjeta is only FDA approved for neoadjuvent use for early stage BC, probably what your MO was referring to. I have also read from others though that they received adjuvant Perjeta for early stage, but needed intervention from their MO with their insurance company. Perhaps if your MO did a peer-to-peer review with your insurance company they would fund it and you could continue.

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  • Jaimieh
    Jaimieh Member Posts: 2,373
    edited July 2014

    I am on person who is getting perjeta after surgery. I did have a recurrence and my insurance didn't give my oncologist a hard time about it. They gave them more of a hard time about approving emmend. So my suggestion is to ask for it and try to get it approved. 

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  • Basia
    Basia Member Posts: 790
    edited July 2014

    I am going to be receiving perjeta and herceptin for 3 years. This is a recurrence for me, so I guess the insurance company doesn't want to fight it.  MY MO also has me down as stage 4 because of the recurrence so maybe that is why there are no hassles with insurance.

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  • CoastalXPat
    CoastalXPat Member Posts: 83
    edited July 2014

    I'm another early-stage person who got Perjeta during chemo after surgery.  I asked my MO if she had to go through any particular hoops to get insurance approval, and she said no. In fact she said she hasn't been turned down yet because there have been such positive responses, at least in the short term. She also mentioned that she hasn't had problems getting Perjeta for 1 year (along w/Herceptin) for her Stage II and III patients.

    Nonetheless, it sounds like there are still some insurance companies that are saying no. But it doesn't hurt to ask.

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