Cape and Phesgo Combo

Hi, I’m Karen and was diagnosed de Novo with stage 4 breast cancer in 2021 which was HER2- A recent biopsy showed it is now HER2 positive and I’m changing to more suitable treatments.
My oncologist and the Multi Disciplinary Team meeting discussed my case last week and recommended Capecitabine and Phesgo. I was due to start treatment but it has been refused funding, I’m in England. Is there any reason this is the case?

I’m not sure about funding but have HER2 stage 4 breast cancer and am having 3 weekly Herceptin injection and take Anastrazol. Have been on this treatment for nearly 3 years and am keeping the cancer at bay. They may be able to fund alternative treatments like mine. perhaps you need to speak to your consultant about different medications. I am over 65. Age does have some significance where funding is involved. Best of luck.

Thank you for responding. The combination of Phesgo and Cape was recommended by a multi disciplinary team so it’s been disappointing that I was due to receive it today and then it was refused. I’m hoping they sort funding out or agree a different treatment as I’ve now suddenly found myself without treatment which is unsettling. I will look at the drugs you mentioned.

Hi Peanut

Thanks for posting. This sounds like a really difficult and understandably unsettling time for you.

Biopsies of new sites or progression of stage 4 (secondary) breast cancer are commonplace and are done in order to check whether any features of the cancer cells have changed which may open up other treatment options as in your case.

It’s understandable that your MDT have recommended HER 2 directed therapy such as Phesgo (trastuzumab and pertuzumab combined).

However, NICE have approved this treatment when it’s given alongside the chemotherapy drug docetaxel (rather than capecitabine) and to patients who have not been treated with chemotherapy or HER2 therapy before for their secondary breast cancer.

You don’t say what treatment you’ve had up to now, but it’s possible that these maybe the reasons the treatment combination that the MDT have recommended has been refused.

Your treatment team should be able to explain the reason for the refusal and discuss further treatment options available to you.

Macmillan Cancer Support have information on accessing treatment when it’s not available on the NHS.

Please do call our helpline if you would like to talk this through or have any further questions. The helpline team have time to listen, talk things through and signpost you to more support and information if necessary. Your call will be confidential, and the number is free from UK landlines and all mobile networks. The number is 0808 800 6000, (Relay UK -prefix 18001).

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Best wishes


Breast Care Nurse

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