scholarly journals Biosimilar Use in Breast Cancer Treatment: A National Survey of Brazilian Oncologists' Opinions, Practices, and Concerns

2021 ◽  
pp. 1316-1324
Author(s):  
Heloísa M. Resende ◽  
Leandro Ladislau ◽  
Ana Carolina F. Cardoso ◽  
Juliana Dinéia P. Brandão ◽  
Biazi R. Assis ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Treatment ◽  
Breast Cancer Treatment ◽  
Her2 Positive ◽  
Treatment Regimens ◽  
Her2 Positive Breast Cancer ◽  
Level Of Knowledge ◽  
The Cost ◽  
Switching Treatment ◽  
Positive Breast Cancer

PURPOSE Breast cancer is the most common malignancy in Brazilian women, with 66,280 new cases in 2020 (with 20% overexpressing human epidermal growth factor receptor 2 [HER2]). The trastuzumab biosimilar was the first oncology biosimilar approved in Brazil for HER2-positive breast cancer treatment. This study aimed to assess the current level of knowledge of biosimilars, comfort of use, extrapolation indications, and switching of practices among oncologists in Brazil. METHODS A 24-question survey was developed using an online platform that sought information regarding responders' characteristics and use of biosimilars. The survey analyzed the basic knowledge of biosimilars, trastuzumab biosimilars, level of comfort with extrapolation, switching treatment regimens, and opinions concerning the cost of HER2-positive breast cancer therapy. Data were collected between July and September 2019 and included 144 oncologists from five Brazilian regions. RESULTS In total, 95% of respondents could identify the most appropriate definition of biosimilars and 96% felt comfortable prescribing trastuzumab biosimilars. Although 63% of respondents would use the biosimilar in all settings wherein the reference biologic was approved, 35% would use the biosimilar for cases involving metastatic disease. Although 82% of oncologists were in favor of switching from a reference biologic to a biosimilar, 18% would avoid switching regimens. The lack of studies detailing switching to other regimens and the correct timing to switch was the major concern. The cost of HER2 therapy was a significant concern for most oncologists. CONCLUSION Oncologists demonstrated a high level of knowledge of biosimilars and encouraging levels of prescriber use; however, extrapolation and switching treatment regimens are barriers to the effective use of biosimilars in cancer treatment. Efforts should be concentrated on strategies involving medical education programs on biosimilars.

scholarly journals 2SPD-010 Assessment of pertuzumab use for her2-positive breast cancer treatment

2018 ◽  
Author(s):  
JF Marin Pozo ◽  
M Merino Almazan ◽  
A Sanchez Ruiz ◽  
A Lopez Lopez ◽  
R Claramunt Garcia ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Treatment ◽  
Breast Cancer Treatment ◽  
Her2 Positive ◽  
Her2 Positive Breast Cancer ◽  
Positive Breast Cancer

scholarly journals Cost-Effectiveness Analysis of Trastuzumab Emtansine as Second-Line Therapy for HER2 Positive Breast Cancer in China

2020 ◽  
Author(s):  
Huahua Zhang ◽  
Yandong Zhang ◽  
Chaonan Huang ◽  
Jiangfeng Wang
Keyword(s):  
Breast Cancer ◽  
Cost Effectiveness ◽  
Trastuzumab Emtansine ◽  
Second Line ◽  
Her2 Positive ◽  
Second Line Therapy ◽  
Her2 Positive Breast Cancer ◽  
Line Therapy ◽  
The Cost ◽  
Positive Breast Cancer

Abstract ObjectiveTo evaluate the cost-effectiveness of trastuzumab emtansine (T-DM1) as the second-line treatment for patients with human epidermal growth factor receptor-2 (HER2) positive breast cancer from the Chinese healthcare perspective. Capecitabine (Cap), capecitabine + lapatinib (Cap+Lap), capecitabine + trastuzumab (Cap+Tra), capecitabine + trastuzumab + pertuzumab (Cap+Tra+Pre) were selected as comparators.MethodsA three-state Markov simulation model was performed. The state transition probabilities were estimated based on the results of a published network meta-analysis, and utilities were derived from the published literature. The costs populated in the model were acquired from the local charge or previously published studies. Univariate sensitive analysis and probabilistic sensitivity analyses were performed to test the robustness of the results.ResultsTreatment with T-DM1 was estimated to increase the cost by $109,683.7, $106,003.7, $94,212.2, and $63,214.9, and yield a gain of 0.544 quality-adjusted life years (QALYs), 0.383 QALYs, 0.367 QALYs, 0.087 QALYs in comparison with Cap, Cap+Lap, Cap+Tra, and Cap+Tra+Pre, respectively. Corresponding incremental cost-effectiveness ratios (ICERs) were $201,624.4, $276,772.1, $256,709.0, and $726,608.0 per QALY. The probabilities of T-DM1 as the dominant option were 0% at the WTP threshold of $30,829.3/QALY.ConclusionsT-DM1, as second-line therapy in the treatment of HER2 positive breast cancer, is not a cost-effective option in China. Given the significant clinical efficacy, an appropriate price reduction of T-DM1 is required to benefit more HER2 positive breast cancer patients.

scholarly journals Comparative Efficacy and Tolerability of Neoadjuvant Immunotherapy Regimens for Patients with HER2-Positive Breast Cancer: A Network Meta-Analysis

2019 ◽  
Vol 2019 ◽  
pp. 1-14 ◽  
Author(s):  
Di Wu ◽  
Tiejun Chen ◽  
Han Jiang ◽  
Chongyang Duan ◽  
Xinjian Zhang ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Meta Analysis ◽  
Random Effect ◽  
Poor Performance Status ◽  
Her2 Positive ◽  
Treatment Regimens ◽  
Her2 Positive Breast Cancer ◽  
Neoadjuvant Immunotherapy ◽  
Significant Difference ◽  
Positive Breast Cancer

This network meta-analysis addresses the need for evidence-based best-practice treatment regimens for HER2-positive breast cancer. We compared the relative efficacy and tolerability of currently available HER2-positive neoadjuvant immunotherapy regimens based on systematic searches of available randomized controlled trials (RCTs) data. Based on intention-to-treat principle, pathological complete response (pCR), overall serious adverse events (SAEs), and breast-conserving surgery (BCS) rate were analyzed using random-effect, Bayesian network meta-analysis, and standard pairwise meta-analysis. 16 RCTs (3868 patients) were included. Analyzed treatment regimens were as follows: chemotherapy+trastuzumab+pertuzumab (CTP), trastuzumab emtansine+pertuzumab (MP), chemotherapy+trastuzumab (CT), chemotherapy+pertuzumab (CP), trastuzumab+pertuzumab (TP), chemotherapy+trastuzumab+lapatinib (CTL), and chemotherapy+lapatinib (CL), and chemotherapy (C) alone. We found that, for the chance of achieving pCR, CTP was ranked first (SUCRA: 97%), followed by CTL, MP, and CT (SUCRA: 80%, 75%, and 55%, resp.). MP provided the safest regimen (SUCRA: 97%), then TP, C, and TPC (SUCRA: 82%, 76%, and 47%, resp.). CTL proved the most toxic therapy (SUCRA: 7%). No significant difference between neoadjuvant regimens was identified for BCS. Hormone receptor status did not impact ORs for pCR in any regimen. In conclusion, our findings support CTP as the optimum neoadjuvant regimen for HER2-positive breast cancer, with the best pCR and acceptable toxicity compared with CT. MP provides a therapeutic option for patients with poor performance status.

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