Medical Oncologists’ Perceptions of Newly Launched Perjeta are Very Promising, Despite Initial Concerns of Increased Cost Associated with Combining Two Premium-Priced Monoclonal Antibodies to Treat HER2-Positive Breast Cancer
BioTrends Research Group, one of the world’s leading research and advisory firms for specialized biopharmaceutical issues, finds that Roche/Genentech’s Perjeta (pertuzumab) which has been available in the U.S. for one month has a positive initial perception by medical oncologists. Perjeta is a first-in-class HER-dimerization inhibitor that was approved by the U.S. Food and Drug Administration in June 2012.
Perjeta is indicated in the first-line setting for metastatic HER2-positive breast cancer in combination with Roche/Genentech’s Herceptin (trastuzumab) and docetaxel. Medical oncologists report that the Perjeta regimen has efficacy advantages over other commonly used regimens on measures of progression free survival and potential overall survival data (clinical study not completed).
“Medical oncologists that were interviewed as part of this study pointed out that the increase in median progression free survival of over six months is a significant advance in the treatment of HER2-positive metastatic breast cancer,” said BioTrends Oncology Therapeutic Director Dan Winkelman. “This type of advancement in the treatment of breast cancer has not been seen since Herceptin was launched over a decade ago.”
Medical oncologists also report that key barriers to increased usage of Perjeta are concerns over cardiotoxicities, lack of finalized overall survival data and increased cost. Despite the initial concerns over cost, the vast majority of medical oncologists who are early adopters of Perjeta, rated the managed care approval process to be easy to moderate with no respondents giving it a negative rating for impacting prescribing. The dearth of reimbursement issues could be based on medical oncologists’ reported high likelihood of prescribing it as indicated in the first-line metastatic HER2-positive setting, instead of prescribing it in later lines or in the adjuvant setting.
Roche/Genentech is also developing Trastuzumab-DM1 (T-DM1) which is a novel antibody-drug conjugate designed to specifically target HER2 overexpressing cells. This monoclonal antibody linked with a cytotoxic agent is in development for metastatic HER2-positive breast cancer patients in the second-line setting. Respondents report that T-DM1 has the fourth highest unaided awareness for therapies to treat metastatic breast cancer, despite the fact this agent is in late stage development and is not yet available for breast cancer treatment, indicating an exceptionally high level of pre-market awareness.
In terms of therapies in development to treat advanced (metastatic) breast cancer outside of Roche/Genentech‘s development activities, medical oncologists have the highest level of interest in Boehringer Ingelheim’s Afatinib (tomtovok) which is a next generation dual EGFR/HER2 inhibitor and Novartis’ recently approved Afinitor (everolimus) an mTOR inhibitor.
is a series of four post-launch syndicated reports designed to track the uptake of Perjeta and TDM-1 at launch (1 month after product availability), 6 months, and 1 year. T-DM1 is also expected to be launched by Roche/Genentech in HER2-positive metastatic breast cancer patient population, so an additional wave of research will be added to this study. LaunchTrends are syndicated reports that track the trial, adoption and usage of new products from launch through maturity. For this report, BioTrends surveyed 74 medical oncologists based in the U.S. and conducted qualitative interviews with a subset of 15 of the respondents in July / August 2012. BioTrends will continue to track the uptake of Perjeta in the next wave in this report series, which will be fielded in December 2012.
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