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The 840 mg/420 mg Q4W and 840 mg Q6W alternative dosing regimens decrease median steady-state Ctrough by ∼40% compared to the approved regimen, and less then 90% of patients will be above the target Ctrough . Thus, the alternative 840 mg/420 mg Q4W and 840 mg Q6W pertuzumab dosing regimens are not recommended. Flexibility for IV PERJETA-based regimens is available with an alternative route of pertuzumab administration (subcutaneous vs intravenous). This article is protected by copyright. All rights reserved. Paraneoplastic pemphigus (PN