Pfizer works to get 'wait-and-see' doctors on board the Ibrance train

Pfizer's Ibrance, launched in 2015, was the first approved med in the CDK 4/6 class. (Pfizer)

MUNICH—Evidence in favor of the relatively new CDK 4/6 class of breast cancer drugs, which stars Pfizer’s Ibrance, continues to pile up—but it hasn’t yet been enough to convince some doctors to give the meds a try.

“Depending on the data source you look at,” about 60%-plus of women receive a CDK 4/6-based regimen as their first treatment for metastatic HR-positive, HER2-negative breast cancer, Pfizer Oncology Global President Andy Schmeltz said over the weekend at the European Society for Medical Oncology annual meeting. That’s “pretty impressive” for a class that just hit the scene in 2015.

But it also means about 40% of docs are reaching for another therapy, despite “lots of data showing that CDK … plus hormone therapy is a better option,” Schmeltz said. About 20% of patients still receive hormone-based therapy on its own, without Ibrance or newer rivals Kisqali from Novartis or Verzenio from Eli Lilly. And the other 20% receive chemo first.

Free Daily Newsletter

Like this story? Subscribe to FiercePharma!

Biopharma is a fast-growing world where big ideas come along daily. Our subscribers rely on FiercePharma as their must-read source for the latest news, analysis and data on drugs and the companies that make them. Sign up today to get pharma news and updates delivered to your inbox and read on the go.

RELATED: Pfizer's narrow Ibrance survival miss could still sway doctors in its favor, executives say

While Schmeltz acknowledged that chemo might be the way to go in some cases—it “might be appropriate … to debulk the tumor,” he said, in advance of surgery—but those cases likely don’t add up to 20%.

Instead, the holdout clinicians are likely going with “kind of a wait-and-see approach,” putting it up to Pfizer, and rivals Novartis and Lilly Oncology, to come through and change their minds.

RELATED: The top 15 best-selling cancer drugs in 2022 - Ibrance

That approach is one that drugmakers have seen across various areas of oncology for years, Dennis Slamon, M.D., Ph.D., an investigator for a recent Kisqali study, said earlier this year. “It’s going to be interesting” to see how prescribing patterns play out among docs faced with the option of offering [Novartis'] Kisqali earlier in treatment, he said, referencing trends that played out around Roche blockbuster Herceptin, now the standard of care in HER-positive breast cancer.

With that drug, doctors—who “tend to be quite conservative in their approach,” Slamon said—continued to hold back until after further lines of chemo, even after data rolled out supporting its use as a first-up treatment.

RELATED: Pfizer bows first Ibrance TV spot as Novartis revs up with rival breast cancer med Kisqali

But Pfizer, for one, isn’t planning on waiting around. It’s using sales reps, field-based medical reps, direct-to-consumer advertising and “the full range of medical and marketing efforts” to try to change minds in the oncology community, Schmeltz said.

“In different countries, we customize the mix based on the dynamics locally, but we’re always tweaking and always looking at how to optimize our use of resources,” he added.

Suggested Articles

FDA officials say Novartis took too long to launch a formal probe into allegations of Zolgensma data manipulation.

Should Johnson & Johnson owe billions to fix Oklahoma's opioid crisis? After weeks of trial testimony, a judge will have his say Monday afternoon.

After Endo and Allergan agreed to settle with two Ohio counties on opioid charges this week, the state’s AG has a message: You’re not off the hook.