Roche’s Perjeta sees ‘impressive’ survival rates
pharmafile | September 29, 2014 | News story | Sales and Marketing | Cancer, ESMO, Perjeta, Roche, breast, madrid
Roche’s oncology drug Perjeta combined with other medicines can help certain breast cancer patients live longer.
This is according to new trial data from the Swiss firm, presented at a conference of the European Society for Medical Oncology (ESMO) in Madrid over the weekend.
It shows that the combination treatment of Perjeta (pertuzumab) with Roche’s ageing blockbuster drug Herceptin (trastuzumab) and chemotherapy agent docetaxel can extend the survival of women with advanced HER2+ breast cancer by 15.7 months more than the current standard treatment.
All of these drugs can also increase median overall survival (OS) by four and a half years – an OS of 56.5 months vs 40.8 months for standard of care, Herceptin plus docetaxel alone.
In combination with Herceptin and docetaxel, Perjeta has in previous trials been shown to improve progression free survival (PFS) by just over six months more than Herceptin and chemotherapy.
But this latest OS data, the golden endpoint in all oncology studies, will be a major boost for Perjeta and its drug’s sales prospects, which has been on the market for nearly two years. Current estimates for the drug see sales of $3.1 billion a year by 2018.
“These results are impressive. They show a magnitude of survival benefit which we have never seen before in advanced breast cancer, let alone this particular type, previously regarded as having a poor prognosis and being difficult to treat,” explains Professor David Miles, consultant medical oncologist, Mount Vernon Cancer Centre and UK study lead for the trial.
He goes on: “The introduction of Herceptin made a huge difference for our patients but this strategy of combining Herceptin with this second HER2-targeted antibody with complementary mechanisms, means that we are able to control the cancer and prolong survival for even longer.
“The observation that women with HER2-positive metastatic breast cancer can live alongside their disease for so many years is frankly unprecedented. These data represent a significant step forward in the fight against breast cancer with combination therapies such as this paving the way for cancer treatments in the future.”
Market access and price concerns
Dr Sarah Rawlings, assistant director of policy and information at UK charity Breakthrough Breast Cancer, echoes Prof Miles, saying: “These results are very impressive – it’s unusual to see results this good for a secondary breast cancer treatment. Perjeta is a well-tolerated drug and we know from speaking to our supporters that it can greatly improve quality of life.”
But in the UK, Perjeta costs £2,395 per 420mg vial and as patients need double that dose initially and then one vial every three weeks, the total cost adds up to more than £43,000 a year.
NICE and its Scottish counterpart the SMC are both currently minded not to recommend the treatment, given its high price. It is still available for patients in England via the £280 million a year Cancer Drugs Fund, but this is set to end in 2016.
Rawlings says: “We were very disappointed when both NICE and the Scottish Medicines Consortium [SMC] rejected Perjeta for routine use on the NHS last year on the basis of cost but it’s not the end of the road.
“NICE have not yet issued their final guidance, the SMC is reassessing it and we know that the manufacturer will have offered some discount to help push it through in Scotland so we await the results of these appraisals with great interest.
“Whilst women in England can currently get access to Perjeta through the Cancer Drugs Fund, unfortunately there is no such allowance for the rest of the UK meaning that highly effective but incredibly expensive drugs are not routinely available to those that need them.”
Ben Adams
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