Training Example: Puma Biotechnology (NERLYNX) – Review the Data, Give Your Score & Compare to the Real AI Evaluation

[IMG: Early-stage and metastatic HER2+ breast cancer patient]
[IMG: Early-stage and metastatic HER2+ breast cancer patient]
[IMG: Early-stage and metastatic HER2+ breast cancer patient]
Get started...See resources that may help you start and stay with NERLYNX.Learn moreReduce your risk...In a clinical trial, NERLYNX reduced the risk of cancer returning for people with early-stage HER2+ breast cancer after trastuzumab-based therapy.Learn more about NERLYNX resultsGet support...Our mentors and support staff are here to provide educational resources and help you through treatment.Learn moreGet started...See resources that may help you start and stay with NERLYNX.Learn moreReduce your risk...In a clinical trial, NERLYNX reduced the risk of cancer returning for people with early-stage HER2+ breast cancer after trastuzumab-based therapy.Learn more about NERLYNX results
[H3] What is HER2+ breast cancer?
What is HER2+ breast cancer?Some people with breast cancer have a gene mutation that causes their cells to make too much of the HER2 (human epidermal growth factor receptor 2) protein. HER2 protein tells cells to grow and divide. If you have too much, your cells may grow faster than normal, and behave aggressively—this causes HER2+ breast cancer.
[H3] What can I do to reduce the risk?
What can I do to reduce the risk?The risk of recurrence in people with early-stage HER2+ breast cancer can be as high as 25% within 10 years. Talk to your doctor to see if extended adjuvant therapy (such as NERLYNX) after trastuzumab-based treatment is right for you to help reduce that risk.
[H3] What’sNERLYNX?
What’s NERLYNX?NERLYNX is a once-a-day, oral treatment for adults with HER2+ breast cancer taken after trastuzumab-based therapy. With NERLYNX, you can help further reduce the risk that your breast cancer will return.Learn more about how NERLYNX works.
[H3] What is HER2+ breast cancer?
Some people with breast cancer have a gene mutation that causes their cells to make too much of the HER2 (human epidermal growth factor receptor 2) protein. HER2 protein tells cells to grow and divide. If you have too much, your cells may grow faster than normal, and behave aggressively—this causes HER2+ breast cancer.
[H3] What can I do to reduce the risk?
The risk of recurrence in people with early-stage HER2+ breast cancer can be as high as 25% within 10 years. Talk to your doctor to see if extended adjuvant therapy (such as NERLYNX) after trastuzumab-based treatment is right for you to help reduce that risk.
[H3] What’s NERLYNX?
NERLYNX is a once-a-day, oral treatment for adults with HER2+ breast cancer taken after trastuzumab-based therapy. With NERLYNX, you can help further reduce the risk that your breast cancer will return.Learn more about how NERLYNX works.
[H3] What is NERLYNX used for?
NERLYNX is a prescription medicine used alone to treat adults with early-stage human epidermal growth factor receptor 2 (HER2)-positive breast cancer and who have previously been treated with trastuzumab-based therapy.NERLYNX is also used with a medicine called capecitabine to treat adults with HER2-positive breast cancer that has spread to other parts of the body (metastatic) and who have received 2 or more anti-HER2 therapy medicines for metastatic breast cancer.It is not known if NERLYNX is safe and effective in children.Are you worried about HER2+ Breast Cancer Recurrence?Patients providing their experiences were compensated for their time. Other patients may have a different experience.Samantha Shares Why She Took NERLYNXPatients providing their experiences were compensated for their time. Other patients may have a different experience.Mentor program*If you are considering or already being treated with NERLYNX, our mentor program connects you with someone who has taken NERLYNX.†We’re ready to chat!To talk to a mentor, call 1‑855‑816‑5421 or sign up below.*The mentor program is here for you with support and resources. Your healthcare team should always be your primary source of information for treatment decisions.†Puma mentors are compensated for their time. Other patients may have a different experience.
[H3] Our support services are designed with you in mind.
Currently taking or thinking about taking NERLYNX? Sign up here to receive information and updates.By clicking this link, you will be leaving the NERLYNX website and will be redirected to a third party site.By clicking this link, you will be leaving the NERLYNX website and will be redirected to another web page.All information collected will be used for sending updates only and will not be shared with third parties other than those contracted with Puma to administer and support the program. By providing your email you are agreeing to receive communications. For more details, see our Privacy Policy.
[H2]
NERLYNX is a prescription medicine used alone to treat adults with early-stage human epidermal growth factor receptor 2 (HER2)-positive breast cancer and who have previously been treated with trastuzumab-based therapy.NERLYNX is also used with a medicine called capecitabine to treat adults with HER2-positive breast cancer that has spread to other parts of the body (metastatic) and who have received 2 or more anti-HER2 therapy medicines for metastatic breast cancer.It is not known if NERLYNX is safe and effective in children.What is NERLYNX tablets?NERLYNX is a prescription medicine used alone to treat adults with early-stage human epidermal growth factor receptor 2 (HER2)-positive breast cancer and who have previously been treatedIMPORTANT SAFETY INFORMATIONWhat is the most important information I should know about NERLYNX (ner links)?NERLYNX may cause serious side effects, including:Diarrhea. Diarrhea is a common side effect of NERLYNX, but it can also be severe. Diarrhea may lead to loss of too much body salts and fluid, which can cause dehydration. Your healthcare provider will prescribe NERLYNX in one of two ways to help manage diarrhea:IMPORTANT SAFETY INFORMATIONWhat is the most important information I should know about NERLYNX (ner links)?NERLYNX may cause serious side effects, including:Diarrhea. Diarrhea is a common side effect of NERLYNX, but it can also be severe. Diarrhea may lead to loss of too much body salts and fluid, which can cause dehydration. Your healthcare provider will prescribe NERLYNX in one of two ways to help manage diarrhea:What is NERLYNX tablets?NERLYNX is a prescription medicine used alone to treat adults with early-stage human epidermal growth factor receptor 2 (HER2)-positive breast cancer and who have previously been treated with trastuzumab-based therapy.NERLYNX is also used with a medicine called capecitabine to treat adults with HER2-positive breast cancer that has spread to other parts of the body (metastatic) and who have received 2 or more anti-HER2 therapy medicines for metastatic breast cancer.It is not known if NERLYNX is safe and effective in children.IMPORTANT SAFETY INFORMATIONWhat is the most important information I should know about NERLYNX (ner links)?NERLYNX may cause serious side effects, including:Diarrhea. Diarrhea is a common side effect of NERLYNX, but it can also be severe. Diarrhea may lead to loss of too much body salts and fluid, which can cause dehydration. Your healthcare provider will prescribe NERLYNX in one of two ways to help manage diarrhea:Full dose of NERLYNX:Your healthcare provider will prescribe the antidiarrheal medicine loperamide for you during your first 2 months (56 days) of treatment with NERLYNX and then as needed. Your healthcare provider will tell you exactly how much and how often to take this medicine.If you are prescribed the full dose of NERLYNX from the start of your treatment, be sure that your healthcare provider also prescribes antidiarrheals with NERLYNX. You should start taking loperamide with your first dose of NERLYNX.After 2 months (56 days) of treatment with NERLYNX, follow your healthcare provider’s instructions about taking loperamide as needed to control diarrhea. A lower starting dose of NERLYNX:Your healthcare provider will start you on a lower dose of NERLYNX for the first 2 weeks of treatment and then increase you to a full dose NERLYNX regimen. Tell your healthcare provider right away if you develop diarrhea; you may be prescribed loperamide as needed.To help prevent or reduce diarrhea during treatment with NERLYNX:Your healthcare provider may also need to give you additional antidiarrheals, fluids, and electrolytes to manage diarrhea when you start treatment with NERLYNX. Follow your healthcare provider’s instructions on how to take antidiarrheal medicines.Always take antidiarrheals exactly as your healthcare provider tells you.While taking antidiarrheals, you and your healthcare provider should try to keep the number of bowel movements that you have at 1 or 2 bowel movements each day.Tell your healthcare provider if you have more than 2 bowel movements in 1 day, or you have diarrhea that does not go away. Call your healthcare provider right away if you have severe diarrhea or if you have diarrhea along with weakness, dizziness, or fever.Your healthcare provider may change your dose of NERLYNX, temporarily stop, or completely stop NERLYNX if needed to manage your diarrhea.See “What are the possible side effects of NERLYNX?” for more information about side effects.Before taking NERLYNX, tell your healthcare provider about all of your medical conditions, including if you:have liver problems. You may need a lower dose of NERLYNX.are pregnant or plan to become pregnant. NERLYNX can harm your unborn baby. If you are a female who can become pregnant:Your healthcare provider should do a pregnancy test before you start taking NERLYNX.You should use effective birth control (contraception) during treatment and for at least 1 month after your last dose of NERLYNX.Talk with your healthcare provider about forms of birth control that you can use during this time.Tell your healthcare provider right away if you become pregnant during treatment with NERLYNX.Males with female partners who can become pregnant should use effective birth control during treatment and for 3 months after the last dose of NERLYNX.are breastfeeding or plan to breastfeed. It is not known if NERLYNX passes into your breast milk. Do not breastfeed during treatment and for at least 1 month after your last dose of NERLYNX.Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements.Especially tell your healthcare provider if you take medicines used to decrease stomach acid, called proton pump inhibitors or PPIs. You should avoid taking these medicines during treatment with NERLYNX.What should I avoid while taking NERLYNX?You should avoid eating products that contain grapefruit during treatment with NERLYNX.What are the possible side effects of NERLYNX?NERLYNX may cause serious side effects, including:See “What is the most important information I should know about NERLYNX?”Liver problems. Changes in liver function tests are common with NERLYNX. Your healthcare provider should do blood tests before you begin treatment, monthly during the first 3 months, and then every 3 months as needed during treatment with NERLYNX. Your healthcare provider will stop your treatment with NERLYNX if your liver tests show severe problems. Call your healthcare provider right away if you get any of the following signs or symptoms of liver problems:tirednessnauseavomitingpain in the right upper stomach-area (abdomen)feverrashitchingyellowing of your skin or whites of your eyesThe most common side effects of NERLYNX when used alone include:diarrheanauseastomach-area (abdomen) paintirednessvomitingrashdry or inflamed mouth, or mouth soresdecreased appetitemuscle spasmsupset stomachnail problems including color changedry skinswelling of your stomach-areanosebleedweight lossurinary tract infectionThe most common side effects of NERLYNX when used with capecitabine include:diarrheanauseavomitingdecreased appetiteconstipationtiredness/weaknessweight lossdizzinessback painjoint painurinary tract infectionupper respiratory tract infectionswelling of your stomach-areakidney problemsmuscle spasmsThese are not all of the possible side effects of NERLYNX. For more information, ask your Healthcare Provider.Tell your healthcare provider if you have any side effects that bother you or that does not go away. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1‑800‑FDA‑1088.Please see Patient Information.By clicking this link, you will be leaving the NERLYNX website and will be redirected to another web page.By clicking this link, you will be leaving the NERLYNX website and will be redirected to a third party site.Diarrhea is a common side effect of NERLYNX, but it can also be severe. Diarrhea may lead to loss of too much body salts and fluid, which can cause dehydration.Always talk to your healthcare provider about side effects and how to manage them. Here are some diet and lifestyle tips to keep in mind that may help manage diarrhea:
[IMG: low fiber, high protein and potassium foods]
Try foods that are low in fiber and high in potassium.
[IMG: eat smaller meals]
Eat smaller, more frequent meals throughout the day.
[IMG: stay hydrated]
Stay well hydrated. Drink up to 8 to 12 glasses of clear liquid every day.
[IMG: avoid dairy products]
Avoid dairy products (except for yogurt).
[IMG: try brat diet]
Try the BRAT diet: Bananas, Rice, Applesauce, and Toast.
[IMG: try probiotics]
Try probiotics, like in yogurt or dietary supplements, to help digestion.

[IMG: nerlynx patient]
[IMG: nerlynx patient]
[IMG: nerlynx patient]
“This is a fighting chance to help reduce my risk...So I took it.”—Sherry H, treated with NERLYNXTopHow does NERLYNX work?NERLYNX in women with early-stage and metastatic HER2+ breast cancerTips for taking NERLYNXHow do I manage diarrhea?Working with your healthcare teamPatients providing their experiences were compensated for their time. Other patients may have a different experience.
[H2] How does NERLYNX work?
NERLYNX is a small molecule targeted therapy that works inside your cells and helps stop HER2 protein signals.
[IMG: nerlynx moa healthy cell]
[H2] NERLYNX in women with early-stage and metastatic HER2+ breast cancer
Early-stageMetastatic
[H2] Early-stage
In early-stage HER2+ breast cancer
[H3] What should I know about how NERLYNX was studied?
NERLYNX was studied in a phase 3 clinical trial called ExteNET. The safety and effectiveness of NERLYNX were evaluated over 2 years in women with early-stage HER2+ breast cancer.
[IMG: 34 percent lower risk of recurrence in early-stage HER2+ breast cancer clinical trial]
Who was in the study?The study included 2,840 women with either hormone receptor–positive (HR+) or hormone receptor–negative (HR−) early-stage HER2+ breast cancer. All women had previously completed trastuzumab-based treatment.What were the treatment groups in this study?Those in the study were randomly assigned to a treatment group: 1,420 received NERLYNX and 1,420 received placebo (an inactive substance that looked the same as and was given the same way as NERLYNX). The effects of NERLYNX were compared to the effects of the placebo.In this clinical study, NERLYNX reduced the risk of recurrence by 34% at 2 years. This was the primary endpoint of the trial.In absolute numbers, 94.2%  of the women (1,338 out of 1,420) who took NERLYNX in the study did not have cancer return after 2 years, compared to 91.9% of the women (1,305 out of 1,420) who took placebo.With NERLYNX, you may help further reduce the risk that your HER2+ breast cancer will return.Individual results may vary.Talk to your doctor for more information on this data.
[H3] Is there any other data on NERLYNX to ask my doctor about?
After the 2-year analyses, 75% of the women (2,117 out of 2,840) agreed to continue being evaluated. The 5-year analyses showed a similar reduction in risk of recurrence.NERLYNX was studied in people with HER2+ breast cancer who were HR+ as well.The 5-year analyses looked at 1,334 of the women with HR+ breast cancer. Of these women, 670 started with NERLYNX and 664 started with placebo within 1-year of treatment with trastuzumab.Most of these women took endocrine (hormone) therapy while on NERLYNX.90.8% of the women (608 out of 670) in the NERLYNX group did not have their cancer return after 5 years, compared to 85.7% of the women (569 out of 664) who took placebo. This resulted in a 42% reduction in the risk of recurrence in these women with HER2+ HR+ early-stage breast cancer.The analysis for reduction in risk of recurrence for patients with HR+ at 5-years was done after the study was completed. It is important that you know no conclusions can be drawn from this analysis.Individual results may vary.Talk to your doctor for more information on this data.
[H3] Is there more about the 5-year special analysis that I should know about?
This 5-year analysis also observed a 59% reduction in the risk of central nervous system (CNS) metastases among women with early-stage HER2+ HR+ breast cancer who started NERLYNX within 1 year of treatment with trastuzumab. A CNS metastasis is cancer that has spread to parts of the CNS, such as the brain or spinal cord.In absolute numbers, 98.4% of the women (659 out of 670) who took NERLYNX did not experience a CNS recurrence or death from any cause, compared to the 95.7% of the women (635 out of 664) who took placebo.The analysis for reduction in risk of developing CNS metastasis at 5-years was done after the study was completed. It is important that you know no conclusions can be drawn from this analysis.Individual results may vary.Talk to your doctor for more information on this data.Mentor program* If you are considering or already being treated with NERLYNX, our mentor program connects you with someone who has taken NERLYNX.†We’re ready to chat!To talk to a mentor, call 1‑855‑816‑5421.*The mentor program is here for you with support and resources. Your healthcare team should always be your primary source of information for treatment decisions.†Puma mentors are compensated for their time. Other patients may have a different experience.
[H3] I have early-stage HER2+ breast cancer. How do I take my NERLYNX?
NERLYNX is an oral medicine that you take once a day at home. Talk to your doctor about the correct dosage for you. Your doctor may start you off with a lower dose of NERLYNX and then gradually increase to your full dosage.Here’s an example of what dose escalation with NERLYNX may look like:
[IMG: nerlynx dose escalation schedule]
[IMG: nerlynx dose escalation schedule]
Your doctor may also prescribe you an antidiarrheal such as loperamide when you start treatment and then as needed. Talk to your doctor about how much and how often to take this medicine. Take a look at our Antidiarrheal Support Program to see if it could help you.‡Learn more
[IMG: how to take nerlynx]
[IMG: how to take nerlynx]
‡Limitations apply. Puma Biotechnology reserves the right to rescind, revoke, or amend this program without notice. For full terms and conditions, call 1-855-816-5421.§Take NERLYNX exactly as your healthcare provider tells you to take it. Your healthcare provider may change your dosage of NERLYNX if needed.For more information on the benefits of NERLYNX, download the patient brochure.
[IMG: nerlynx download button]
[H3] What side effects could I experience?
Diarrhea is the most common side effect of taking NERLYNX, and can be severe. Diarrhea may lead to loss of too much body salt and fluid, which can cause dehydration.Call your doctor right away if you have severe diarrhea or experience diarrhea along with weakness, dizziness, or fever.NERLYNX may cause other serious side effects including liver problems. NERLYNX can also harm your unborn baby. You should use effective birth control during and for at least one month after treatment.Here are some other commonly reported side effects when NERLYNX is used alone to treat early-stage HER2+ breast cancer:NauseaStomach-area (abdomen) painTirednessVomitingRashDry or inflamed mouth, or mouth soresDecreased appetiteMuscle spasmsUpset stomachNail problems including color changeDry skinSwelling of your stomach-areaNosebleedWeight lossUrinary tract infectionThese are not all of the possible side effects of NERLYNX. Tell your healthcare provider if you have any side effects that bother you or that does not go away. You may report side effects to FDA at 1-800-FDA-1088.Please see Important Safety Information below.
[H2] Metastatic
With metastatic HER2+ breast cancer
[H3] Take a stand against progression
“Metastatic” means that the cancer has spread beyond the breast and nearby lymph nodes to other parts of the body. NERLYNX plus capecitabine (an oral chemotherapy) can be taken to help prevent advanced or metastatic HER2+ breast cancer from spreading further.
[H3] Who is NERLYNX right for?
If you've already been treated with 2 or more HER2-directed therapies for metastatic breast cancer (like trastuzumab, T-DM1, and/or pertuzumab), NERLYNX plus capecitabine may be right for you.
[H3] What should I know about the benefits of NERLYNX plus capecitabine?
NERLYNX was studied in a phase 3 trial examining the safety and effectiveness of NERLYNX in combination with capecitabine vs lapatinib plus capecitabine. The clinical trial included 621 people with metastatic HER2+ breast cancer who had previously been treated with 2 or more HER2-directed therapies.
[IMG: 24 percent reduced progression metastatic HER2+ breast cancer trial]
In a clinical study, NERLYNX plus capecitabine reduced the risk of progression by 24%.29% of the women (89 out of 307) in the NERLYNX + capecitabine group did not see their cancer progress over 1 year compared to 15% (47 out of 314) people in the lapatinib + capecitabine group.Individual results may vary.Talk to your doctor for more information on this data.
[IMG: 8.5 months longer response to treatment in metastatic HER2+ breast cancer trial]
In the clinical trial, NERLYNX also gave people a longer response to treatment compared with lapatinib plus capecitabine.**Median of 8.5 months compared to 5.6 months for those taking lapatinib. The 8.5- and 5.6-months durations were calculated only from the percentage of people that responded to therapy (32.8% in the NERLYNX group vs 26.7% in the lapatinib group).Mentor program† If you are considering or already being treated with NERLYNX, our mentor program connects you with someone who has taken NERLYNX.‡We're ready to chat!To talk to a mentor, call 1‑855‑816‑5421.†The mentor program is here for you with support and resources. Your healthcare team should always be your primary source of information for treatment decisions.‡Puma mentors are compensated for their time. Other patients may have a different experience.
[H3] I have metastatic breast cancer. How do I take my NERLYNX?
NERLYNX is an oral medicine that you take once a day. Talk to your doctor about the correct dosage for you. Your doctor may start you off with a lower dose of NERLYNX and then gradually increase to your full dosage.It's important to remember if you're taking NERLYNX for your metastatic breast cancer, you must take it in combination with capecitabine.Here’s an example of what dose escalation with NERLYNX may look like:
[IMG: nerlynx dose escalation schedule]
[IMG: nerlynx dose escalation schedule]
[IMG: nerlynx plus capecitabine metastatic breast cancer combo logo]
[IMG: nerlynx plus capecitabine metastatic breast cancer combo logo]
Your doctor may also prescribe you an antidiarrheal such as loperamide when you start treatment and then as needed. Talk to your doctor about how much and how often to take this medicine. Take a look at our Antidiarrheal Support Program to see if it could help you.§Learn more§Limitations apply. Puma Biotechnology reserves the right to rescind, revoke, or amend this program without notice. For full terms and conditions, call 1-855-816-5421. For more information on the benefits of NERLYNX, download the patient brochure.
[IMG: nerlynx download button]
[H2] What side effects could I experience?
Diarrhea is the most common side effect of taking NERLYNX, and can be severe. Diarrhea may lead to loss of too much body salt and fluid, which can cause dehydration.Call your doctor right away if you have severe diarrhea or experience diarrhea along with weakness, dizziness, or fever.NERLYNX may cause other serious side effects including liver problems. NERLYNX can also harm your unborn baby. You should use effective birth control during and for at least one month after treatment.Here are some other commonly reported side effects when NERLYNX is used in combination with capecitabine to treat metastatic HER2+ breast cancer:NauseaVomitingDecreased appetiteConstipationTiredness/weaknessWeight lossDizzinessBack painJoint painUrinary tract infectionUpper respiratory tract infectionSwelling of your stomach-areaKidney problemsMuscle spasmsThese are not all of the possible side effects of NERLYNX. Tell your healthcare provider if you have any side effects that bother you or that does not go away. You may report side effects to FDA at 1-800-FDA-1088.Please see Important Safety Information below.
[H2] Tips for taking NERLYNX
Here are some tips and procedures for taking your NERLYNX from women and their caregivers who’ve been there: Previous“If I miss a dose of NERLYNX, I skip that dose like my doctor advised and take the next dose at my regularly scheduled time.”8 OF 9“I make sure to never take more than my prescribed dose per day. If I accidentally took too much NERLYNX, I would call my healthcare provider right away or go to the nearest hospital emergency room.”9 OF 9“I set an alarm on my phone, so I always remember to take my NERLYNX exactly as my doctor told me to take it—at the same time every day.”1 OF 9“I trust my doctor, and I know they may change my dosage of NERLYNX if need be.”2 OF 9"I always take mine with food.”3 OF 9“Grapefruit and grapefruit products may interact with my NERLYNX, so it’s important to stay away.”4 OF 9“Never chew, crush, or split your NERLYNX. It’s important that it gets into your system the way it’s supposed to.”5 OF 9“If I take an antacid medicine, I make sure to take NERLYNX 3 hours after the antacid.”6 OF 9“If I take an acid reducer (H2-receptor blocker), I make sure to take NERLYNX at least 2 hours before or 10 hours after.”7 OF 9“If I miss a dose of NERLYNX, I skip that dose like my doctor advised and take the next dose at my regularly scheduled time.”8 OF 9“I make sure to never take more than my prescribed dose per day. If I accidentally took too much NERLYNX, I would call my healthcare provider right away or go to the nearest hospital emergency room.”9 OF 9“I set an alarm on my phone, so I always remember to take my NERLYNX exactly as my doctor told me to take it—at the same time every day.”1 OF 9“I trust my doctor, and I know they may change my dosage of NERLYNX if need be.”2 OF 9 NextDid you know there are educational programs and services that help support NERLYNX accessibility?Check out Puma Patient Lynx™
[H2] How do I manage diarrhea?
Diarrhea is a common side effect of NERLYNX, but it can also be severe. Diarrhea may lead to loss of too much body salts and fluid, which can cause dehydration.For patients with early-stage HER2+ breast cancer, your doctor may start you with a lower dose and slowly increase the dose until you are taking the recommended dosage of 6 pills a day. This can help you adjust to NERLYNX by managing this side effect.Your healthcare provider may prescribe antidiarrheals as needed. Take antidiarrheals exactly as your healthcare provider tells you. Call your healthcare provider right away if you have severe diarrhea or if you have diarrhea along with weakness, dizziness, or fever.NERLYNX can cause other side effects, including serious side effects. Please see below for Important Safety Information and Patient Information.
[H2] Working with your healthcare team
Side effects can occur with NERLYNX. But there are steps you can take to help manage the side effect of diarrhea and see your treatment through.Working with your healthcare team from the beginning is the key to success. Here are some simple steps to help prepare you:
[IMG: information before, at start, and during taking of nerlynx]
[IMG: information before, at start, and during taking of nerlynx]
Managing diarrhea
[IMG: information while taking nerlynx]
[H3] Antidiarrheal Support Program∥
Puma offers vouchers that include access

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[IMG: nerlynx patient conversation]
[IMG: nerlynx patient conversation]
“One thing I know from experience is that you don't have to go through this treatment alone.”—Valerie M, treated with NERLYNXTopBecome an advocate in your careWorking with your healthcare teamPuma Patient Lynx™: NERLYNX support programsPuma Patient Lynx™ helps make NERLYNX accessible and supports your therapy journeyPatients providing their experiences were compensated for their time. Other patients may have a different experience.
[H2] Become an advocate in your care
Taking a stand against recurrence starts with education. And it starts here…
[H4] Advocacy through treatment
Learn about the importance of advocating for yourself through treatment from Sherry H, who was treated with NERLYNX.Sherry was compensated for her time to share her experience.Other patients may have a different experience.
[IMG: questions to ask your doctor about HER2+ breast cancer]
[H4] Questions to ask your doctor about HER2+ breast cancer
No matter where you are in your treatment-planning process, it is important to partner with your doctor. This downloadable brochure helps you prepare a list of the important questions.PDF (English)
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[IMG: nerlynx patient brochure]
[H4] Patient brochure
Your resource to help you get started with NERLYNX and support you through treatment.PDF (English)
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PDF (Spanish)
[IMG: nerlynx download button]
[H2] Working with your healthcare team
Side effects can occur with NERLYNX. But there are steps you can take to help manage the side effect of diarrhea and see your treatment through.Working with your healthcare team from the beginning is the key to success. Here are some simple steps to help prepare you:
[IMG: information before, at start, and during taking of nerlynx]
[IMG: information before and at start of taking nerlynx]
Managing diarrhea
[IMG: information while taking nerlynx]
Connect with a mentorTo talk to a mentor, call 1‑855‑816‑5421 or sign up below.
[H2] Puma Patient Lynx™: NERLYNX support programs
Puma Patient Lynx™ provides programs and services for support, education, and accessibility. The nurse call center at Puma Patient Lynx™ is available to support you with access to all services by calling 1-855-816-5421 Monday to Friday, 9 AM to 6 PM ET.Limitations apply with this program. Puma Biotechnology reserves the right to rescind, revoke, or amend this program without notice. For full terms and conditions, call 1-855-816-5421.Download the patient brochure for more details about the specialty pharmacy process and delivery of NERLYNX.
[H2] Puma Patient Lynx™ helps make NERLYNX accessible and supports your therapy journey
The following patient support programs and services are available by calling Puma Patient Lynx™ at 1-855-816-5421 Monday to Friday, 9 AM to 6 PM ET.To access NERLYNX’s support programs, download and complete the patient enrollment form: English and Spanish.These programs and services are subject to full terms and conditions including eligibility requirements as applicable. Puma reserves the right to change or discontinue any program or offering at any time.Patient Assistance ProgramNurses can help with questions about NERLYNX and management of side effects*NERLYNX may be provided at no cost for uninsured patients who meet specific financial criteriaInformation is available about nonprofit foundations and other potential resources for patients who need financial assistanceSupport is available to help you understand your insurance coverage and address any access issues related to NERLYNXNERLYNX Quick StartProvides a free 3-week supply of NERLYNX to eligible patients whose access to medicine is delayedAntidiarrheal Support ProgramPuma offers product vouchers that include access to a free supply of certain antidiarrheal medicines. With a prescription, patients can receive up to a 3-month supply of products used for antidiarrheal treatment for free.Patients can obtain a voucher from Puma Patient Lynx or ask your healthcare team or Specialty Pharmacy for a NERLYNX starter kitCo-pay SupportCommercially insured, eligible patients treated with NERLYNX may pay as little as $10 per prescription§Patients can enroll through their specialty pharmacy, dispensing pharmacy clinic, or click here.Mentor Program†If you are considering or already being treated with NERLYNX, our mentor program connects you with someone who has completed NERLYNX treatment. This program is confidential and complimentary.‡We stand together. Let a mentor's story help you gain confidence in your stand against recurrence with NERLYNX. While every experience with NERLYNX is unique, and your doctor should always be your primary source of information for treatment decisions, hearing from someone who has taken NERLYNX helps you:Learn about another person's real-life experiencesUnderstand why they felt NERLYNX was the right step for themGain confidence to take this next step toward reducing the risk that breast cancer will returnLearn about the resources available as you take NERLYNX*This is an informational service. Call center nurses do not offer medical advice.§Patient must have commercial insurance. Offer is not valid under Medicare, Medicaid, or any other federal or state program.†The Puma Mentor Program is not a substitute for discussions with your doctor and healthcare team. Please consult with your provider for treatment and side effect management. Your experience may be different than that of a mentor.‡This program is complimentary and is subject to change or discontinuation by Puma at any time without notice. Mentors are compensated for their time by Puma. Other patients may have a different experience.By clicking this link, you will be leaving the NERLYNX website and will be redirected to a third party site.
[H3] Our support services are designed with you in mind
Currently taking or thinking about taking NERLYNX? Sign up here to receive information and updates.By clicking this link, you will be leaving the NERLYNX website and will be redirected to a third party site.By clicking this link, you will be leaving the NERLYNX website and will be redirected to another web page.All information collected will be used for sending updates only and will not be shared with third parties other than those contracted with Puma to administer and support the program. By providing your email you are agreeing to receive communications. For more details, see our Privacy Policy.What is NERLYNX tablets?NERLYNX is a prescription medicine used alone to treat adults with early-stage human epidermal growth factor receptor 2 (HER2)-positive breast cancer and who have previously been treatedIMPORTANT SAFETY INFORMATIONWhat is the most important information I should know about NERLYNX (ner links)?NERLYNX may cause serious side effects, including:Diarrhea. Diarrhea is a common side effect of NERLYNX, but it can also be severe. Diarrhea may lead to loss of too much body salts and fluid, which can cause dehydration. Your healthcare provider will prescribe NERLYNX in one of two ways to help manage diarrhea:IMPORTANT SAFETY INFORMATIONWhat is the most important information I should know about NERLYNX (ner links)?NERLYNX may cause serious side effects, including:Diarrhea. Diarrhea is a common side effect of NERLYNX, but it can also be severe. Diarrhea may lead to loss of too much body salts and fluid, which can cause dehydration. Your healthcare provider will prescribe NERLYNX in one of two ways to help manage diarrhea:What is NERLYNX tablets?NERLYNX is a prescription medicine used alone to treat adults with early-stage human epidermal growth factor receptor 2 (HER2)-positive breast cancer and who have previously been treated with trastuzumab-based therapy.NERLYNX is also used with a medicine called capecitabine to treat adults with HER2-positive breast cancer that has spread to other parts of the body (metastatic) and who have received 2 or more anti-HER2 therapy medicines for metastatic breast cancer.It is not known if NERLYNX is safe and effective in children.IMPORTANT SAFETY INFORMATIONWhat is the most important information I should know about NERLYNX (ner links)?NERLYNX may cause serious side effects, including:Diarrhea. Diarrhea is a common side effect of NERLYNX, but it can also be severe. Diarrhea may lead to loss of too much body salts and fluid, which can cause dehydration. Your healthcare provider will prescribe NERLYNX in one of two ways to help manage diarrhea:Full dose of NERLYNX:Your healthcare provider will prescribe the antidiarrheal medicine loperamide for you during your first 2 months (56 days) of treatment with NERLYNX and then as needed. Your healthcare provider will tell you exactly how much and how often to take this medicine.If you are prescribed the full dose of NERLYNX from the start of your treatment, be sure that your healthcare provider also prescribes antidiarrheals with NERLYNX. You should start taking loperamide with your first dose of NERLYNX.After 2 months (56 days) of treatment with NERLYNX, follow your healthcare provider’s instructions about taking loperamide as needed to control diarrhea. A lower starting dose of NERLYNX:Your healthcare provider will start you on a lower dose of NERLYNX for the first 2 weeks of treatment and then increase you to a full dose NERLYNX regimen. Tell your healthcare provider right away if you develop diarrhea; you may be prescribed loperamide as needed.To help prevent or reduce diarrhea during treatment with NERLYNX:Your healthcare provider may also need to give you additional antidiarrheals, fluids, and electrolytes to manage diarrhea when you start treatment with NERLYNX. Follow your healthcare provider’s instructions on how to take antidiarrheal medicines.Always take antidiarrheals exactly as your healthcare provider tells you.While taking antidiarrheals, you and your healthcare provider should try to keep the number of bowel movements that you have at 1 or 2 bowel movements each day.Tell your healthcare provider if you have more than 2 bowel movements in 1 day, or you have diarrhea that does not go away. Call your healthcare provider right away if you have severe diarrhea or if you have diarrhea along with weakness, dizziness, or fever.Your healthcare provider may change your dose of NERLYNX, temporarily stop, or completely stop NERLYNX if needed to manage your diarrhea.See “What are the possible side effects of NERLYNX?” for more information about side effects.Before taking NERLYNX, tell your healthcare provider about all of your medical conditions, including if you:have liver problems. You may need a lower dose of NERLYNX.are pregnant or plan to become pregnant. NERLYNX can harm your unborn baby. If you are a female who can become pregnant:Your healthcare provider should do a pregnancy test before you start taking NERLYNX.You should use effective birth control (contraception) during treatment and for at least 1 month after your last dose of NERLYNX.Talk with your healthcare provider about forms of birth control that you can use during this time.Tell your healthcare provider right away if you become pregnant during treatment with NERLYNX.Males with female partners who can become pregnant should use effective birth control during treatment and for 3 months after the last dose of NERLYNX.are breastfeeding or plan to breastfeed. It is not known if NERLYNX passes into your breast milk. Do not breastfeed during treatment and for at least 1 month after your last dose of NERLYNX.Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements.Especially tell your healthcare provider if you take medicines used to decrease stomach acid, called proton pump inhibitors or PPIs. You should avoid taking these medicines during treatment with NERLYNX.What should I avoid while taking NERLYNX?You should avoid eating products that contain grapefruit during treatment with NERLYNX.What are the possible side effects of NERLYNX?NERLYNX may cause serious side effects, including:See “What is the most important information I should know about NERLYNX?”Liver problems. Changes in liver function tests are common with NERLYNX. Your healthcare provider should do blood tests before you begin treatment, monthly during the first 3 months, and then every 3 months as needed during treatment with NERLYNX. Your healthcare provider will stop your treatment with NERLYNX if your liver tests show severe problems. Call your healthcare provider right away if you get any of the following signs or symptoms of liver problems:tirednessnauseavomitingpain in the right upper stomach-area (abdomen)feverrashitchingyellowing of your skin or whites of your eyesThe most common side effects of NERLYNX when used alone include:diarrheanauseastomach-area (abdomen) paintirednessvomitingrashdry or inflamed mouth, or mouth soresdecreased appetitemuscle spasmsupset stomachnail problems including color changedry skinswelling of your stomach-areanosebleedweight lossurinary tract infectionThe most common side effects of NERLYNX when used with capecitabine include:diarrheanauseavomitingdecreased appetiteconstipationtiredness/weaknessweight lossdizzinessback painjoint painurinary tract infectionupper respiratory tract infectionswelling of your stomach-areakidney problemsmuscle spasmsThese are not all of the possible side effects of NERLYNX. For more information, ask your Healthcare Provider.Tell your healthcare provider if you have any side effects that bother you or that does not go away. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1‑800‑FDA‑1088.Please see Patient Information.By clicking this link, you will be leaving the NERLYNX website and will be redirected to another web page.By clicking this link, you will be leaving the NERLYNX website and will be redirected to a third party site.Diarrhea is a common side effect of NERLYNX, but it can also be severe. Diarrhea may lead to loss of too much body salts and fluid, which can cause dehydration.Always talk to your healthcare provider about side effects and how to manage them. Here are some diet and lifestyle tips to keep in mind that may help manage diarrhea:
[IMG: low fiber, high protein and potassium foods]
Try foods that are low in fiber and high in potassium.
[IMG: eat smaller meals]
Eat smaller, more frequent meals throughout the day.
[IMG: stay hydrated]
Stay well hydrated. Drink up to 8 to 12 glasses of clear liquid every day.
[IMG: avoid dairy products]
Avoid dairy products (except for yogurt).
[IMG: try brat diet]
Try the BRAT diet: Bananas, Rice, Applesauce, and Toast.
[IMG: try probiotics]
Try probiotics, like in yogurt or dietary supplements, to help digestion.

[IMG: Early-stage and metastatic HER2+ breast cancer patient closeup]
[IMG: Early-stage and metastatic HER2+ breast cancer patient closeup]
[IMG: Early-stage and metastatic HER2+ breast cancer patient closeup]
“I wanted to do everything possible to reduce the risk of recurrence.”—Edwina L, treated with NERLYNXTopWhat is HER2+ breast cancer?What’s the difference between early-stage and metastatic HER2+ breast cancer?Why should I worry about my cancer coming back?Where could NERLYNX fit in my treatment plan?Patients providing their experiences were compensated for their time. Other patients may have a different experience.Having a HER2+ breast cancer diagnosis can bring with it a range of emotions. Some days you may feel irritable, angry, or hopeless. And there are days where you almost forget your diagnosis and feel like yourself again. But no matter how you’re feeling, it’s important to know the facts about what’s going on with your condition.
[H2] What is HER2+ breast cancer?
You may already know this, but people with HER2+ breast cancer have a gene mutation that causes their cells to make too much of the HER2 protein. HER2 protein tells cells to grow and divide. If you have too much, your cells may grow faster than normal, and behave aggressively—this causes HER2+ breast cancer.HER2+ breast cancer is different from other breast cancers. It grows quicker, tends to be more aggressive, and is more likely to come back or spread, even after other treatments. But there are medicines out there that are made to specifically target the HER2 protein.
[IMG: her2 cell diagram]
[IMG: her2 cell diagram]
[IMG: 1 in 5 people with breast cancer have HER2+]
[H2] What’s the difference between early-stage and metastatic HER2+ breast cancer?
[H3] Early-stage HER2+ breast cancer
Early-stage HER2+ breast cancer is cancer that has not spread beyond the breast and the nearby lymph nodes. Even though it’s treatable, it can still come back after chemotherapy, surgery, radiation, and trastuzumab-based treatment.
[H3] Metastatic HER2+ breast cancer
Metastatic breast cancer, also called stage IV or advanced breast cancer, is cancer that has spread beyond the breast and nearby lymph nodes to other parts of the body.In nearly 1 in 4 people with breast cancer diagnosed at an early stage, the cancer will come back as advanced or metastatic breast cancer. In 6% to 10% of new breast cancer cases, the breast cancer is metastatic from the start. This is called de novo metastatic breast cancer.
[H2] Early-stage HER2+ breast cancer
Early-stage HER2+ breast cancer is cancer that has not spread beyond the breast and the nearby lymph nodes. Even though it’s treatable, it can still come back after chemotherapy, surgery, radiation, and trastuzumab-based treatment.
[H2] Metastatic HER2+ breast cancer
Metastatic breast cancer, also called stage IV or advanced breast cancer, is cancer that has spread beyond the breast and nearby lymph nodes to other parts of the body.In nearly 1 in 4 people with breast cancer diagnosed at an early stage, the cancer will come back as advanced or metastatic breast cancer. In 6% to 10% of new breast cancer cases, the breast cancer is metastatic from the start. This is called de novo metastatic breast cancer.See questions to ask your doctor
[IMG: nerlynx download button]
that may help you better understand HER2+ breast cancer.
[H2] Why should I worry about my cancer coming back?
With breast cancer, there is always some level of risk of the cancer returning. That’s why no matter if your diagnosis was a month ago or years ago, it’s important to know what’s ahead so you and your healthcare team can make plans that could help reduce the risk.
[H3] In early-stage HER2+ breast cancer the risk of recurrence can be as high as
[IMG: early stage HER2+ recurrence risk as high as 25 percent]
[IMG: early stage HER2+ recurrence risk as high as 25 percent]
[H2] Where could NERLYNX fit in my treatment plan?
[IMG: nerlynx in HER2+ treatment plan]
[IMG: nerlynx in HER2+ treatment plan]
In early-stage breast cancer, NERLYNX is an extended adjuvant anti-HER2 targeted medication following trastuzumab-based therapy.Learn more about NERLYNXNo time to scroll?Download this helpful patient brochure
[IMG: nerlynx download button]
and catch up later.
[H3] Our support services are designed with you in mind
Currently taking or thinking about taking NERLYNX? Sign up here to receive information and updates.By clicking this link, you will be leaving the NERLYNX website and will be redirected to a third party site.By clicking this link, you will be leaving the NERLYNX website and will be redirected to another web page.All information collected will be used for sending updates only and will not be shared with third parties other than those contracted with Puma to administer and support the program. By providing your email you are agreeing to receive communications. For more details, see our Privacy Policy.What is NERLYNX tablets?NERLYNX is a prescription medicine used alone to treat adults with early-stage human epidermal growth factor receptor 2 (HER2)-positive breast cancer and who have previously been treatedIMPORTANT SAFETY INFORMATIONWhat is the most important information I should know about NERLYNX (ner links)?NERLYNX may cause serious side effects, including:Diarrhea. Diarrhea is a common side effect of NERLYNX, but it can also be severe. Diarrhea may lead to loss of too much body salts and fluid, which can cause dehydration. Your healthcare provider will prescribe NERLYNX in one of two ways to help manage diarrhea:IMPORTANT SAFETY INFORMATIONWhat is the most important information I should know about NERLYNX (ner links)?NERLYNX may cause serious side effects, including:Diarrhea. Diarrhea is a common side effect of NERLYNX, but it can also be severe. Diarrhea may lead to loss of too much body salts and fluid, which can cause dehydration. Your healthcare provider will prescribe NERLYNX in one of two ways to help manage diarrhea:What is NERLYNX tablets?NERLYNX is a prescription medicine used alone to treat adults with early-stage human epidermal growth factor receptor 2 (HER2)-positive breast cancer and who have previously been treated with trastuzumab-based therapy.NERLYNX is also used with a medicine called capecitabine to treat adults with HER2-positive breast cancer that has spread to other parts of the body (metastatic) and who have received 2 or more anti-HER2 therapy medicines for metastatic breast cancer.It is not known if NERLYNX is safe and effective in children.IMPORTANT SAFETY INFORMATIONWhat is the most important information I should know about NERLYNX (ner links)?NERLYNX may cause serious side effects, including:Diarrhea. Diarrhea is a common side effect of NERLYNX, but it can also be severe. Diarrhea may lead to loss of too much body salts and fluid, which can cause dehydration. Your healthcare provider will prescribe NERLYNX in one of two ways to help manage diarrhea:Full dose of NERLYNX:Your healthcare provider will prescribe the antidiarrheal medicine loperamide for you during your first 2 months (56 days) of treatment with NERLYNX and then as needed. Your healthcare provider will tell you exactly how much and how often to take this medicine.If you are prescribed the full dose of NERLYNX from the start of your treatment, be sure that your healthcare provider also prescribes antidiarrheals with NERLYNX. You should start taking loperamide with your first dose of NERLYNX.After 2 months (56 days) of treatment with NERLYNX, follow your healthcare provider’s instructions about taking loperamide as needed to control diarrhea. A lower starting dose of NERLYNX:Your healthcare provider will start you on a lower dose of NERLYNX for the first 2 weeks of treatment and then increase you to a full dose NERLYNX regimen. Tell your healthcare provider right away if you develop diarrhea; you may be prescribed loperamide as needed.To help prevent or reduce diarrhea during treatment with NERLYNX:Your healthcare provider may also need to give you additional antidiarrheals, fluids, and electrolytes to manage diarrhea when you start treatment with NERLYNX. Follow your healthcare provider’s instructions on how to take antidiarrheal medicines.Always take antidiarrheals exactly as your healthcare provider tells you.While taking antidiarrheals, you and your healthcare provider should try to keep the number of bowel movements that you have at 1 or 2 bowel movements each day.Tell your healthcare provider if you have more than 2 bowel movements in 1 day, or you have diarrhea that does not go away. Call your healthcare provider right away if you have severe diarrhea or if you have diarrhea along with weakness, dizziness, or fever.Your healthcare provider may change your dose of NERLYNX, temporarily stop, or completely stop NERLYNX if needed to manage your diarrhea.See “What are the possible side effects of NERLYNX?” for more information about side effects.Before taking NERLYNX, tell your healthcare provider about all of your medical conditions, including if you:have liver problems. You may need a lower dose of NERLYNX.are pregnant or plan to become pregnant. NERLYNX can harm your unborn baby. If you are a female who can become pregnant:Your healthcare provider should do a pregnancy test before you start taking NERLYNX.You should use effective birth control (contraception) during treatment and for at least 1 month after your last dose of NERLYNX.Talk with your healthcare provider about forms of birth control that you can use during this time.Tell your healthcare provider right away if you become pregnant during treatment with NERLYNX.Males with female partners who can become pregnant should use effective birth control during treatment and for 3 months after the last dose of NERLYNX.are breastfeeding or plan to breastfeed. It is not known if NERLYNX passes into your breast milk. Do not breastfeed during treatment and for at least 1 month after your last dose of NERLYNX.Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements.Especially tell your healthcare provider if you take medicines used to decrease stomach acid, called proton pump inhibitors or PPIs. You should avoid taking these medicines during treatment with NERLYNX.What should I avoid while taking NERLYNX?You should avoid eating products that contain grapefruit during treatment with NERLYNX.What are the possible side effects of NERLYNX?NERLYNX may cause serious side effects, including:See “What is the most important information I should know about NERLYNX?”Liver problems. Changes in liver function tests are common with NERLYNX. Your healthcare provider should do blood tests before you begin treatment, monthly during the first 3 months, and then every 3 months as needed during treatment with NERLYNX. Your healthcare provider will stop your treatment with NERLYNX if your liver tests show severe problems. Call your healthcare provider right away if you get any of the following signs or symptoms of liver problems:tirednessnauseavomitingpain in the right upper stomach-area (abdomen)feverrashitchingyellowing of your skin or whites of your eyesThe most common side effects of NERLYNX when used alone include:diarrheanauseastomach-area (abdomen) paintirednessvomitingrashdry or inflamed mouth, or mouth soresdecreased appetitemuscle spasmsupset stomachnail problems including color changedry skinswelling of your stomach-areanosebleedweight lossurinary tract infectionThe most common side effects of NERLYNX when used with capecitabine include:diarrheanauseavomitingdecreased appetiteconstipationtiredness/weaknessweight lossdizzinessback painjoint painurinary tract infectionupper respiratory tract infectionswelling of your stomach-areakidney problemsmuscle spasmsThese are not all of the possible side effects of NERLYNX. For more information, ask your Healthcare Provider.Tell your healthcare provider if you have any side effects that bother you or that does not go away. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1‑800‑FDA‑1088.Please see Patient Information.By clicking this link, you will be leaving the NERLYNX website and will be redirected to another web page.By clicking this link, you will be leaving the NERLYNX website and will be redirected to a third party site.Diarrhea is a common side effect of NERLYNX, but it can also be severe. Diarrhea may lead to loss of too much body salts and fluid, which can cause dehydration.Always talk to your healthcare provider about side effects and how to manage them. Here are some diet and lifestyle tips to keep in mind that may help manage diarrhea:
[IMG: low fiber, high protein and potassium foods]
Try foods that are low in fiber and high in potassium.
[IMG: eat smaller meals]
Eat smaller, more frequent meals throughout the day.
[IMG: stay hydrated]
Stay well hydrated. Drink up to 8 to 12 glasses of clear liquid every day.
[IMG: avoid dairy products]
Avoid dairy products (except for yogurt).
[IMG: try brat diet]
Try the BRAT diet: Bananas, Rice, Applesauce, and Toast.
[IMG: try probiotics]
Try probiotics, like in yogurt or dietary supplements, to help digestion.