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Study finds Herceptin use can be halved

Published on 17/05/18 at 02:40pm
IMAGE: Tiffany Trojca

A team of researchers from the University of Cambridge and Warwick Clinical Trials have revealed that Roche’s Herceptin is just as effective after a reduced treatment period of six months compared with the standard 12 months, in women with HER2 positive early-stage breast cancer.

This is a significant finding for a few reasons: the main one being that patients could receive less courses of treatment, which was found to be associated with reduced levels of side-effects.

Some of the side-effects were potentially serious, with heart problems a known risk factor for taking the treatment.

During the 4,000 person study, 8% of participants dropped out of the 12 month treatment period while in the six month group only 4% had to stop treatment due to heart problems.

In terms of efficacy, the difference between the two groups was negligible – 89.4% taking the treatment for six months had no signs of cancer four years after the trial while 89.8% were free of disease in the 12 month arm.

Lead study author Professor Helena Earl, Professor of Clinical Cancer Medicine, University of Cambridge and Cancer Research UK Cambridge Centre, said: “The PERSEPHONE trials team, patient advocates who have worked with us on the study and our investigators are very excited by these results. We are confident that this will mark the first steps towards a reduction of Herceptin treatment to six months in many women with HER2-positive breast cancer.

“However, any proposed reduction in effective cancer treatment will always be complex and very challenging, and women currently taking the medication should not change their treatment without seeking advice from their doctor. There is more research to be done to define as precisely as possible the particular patients who could safely reduce their treatment duration. We are poised to do important translational research analysing blood and tissue samples collected within the trial to look for biomarkers to identify subgroups of different risk where shorter/longer durations might be tailored.”

The potential benefits of reducing treatment length extend beyond being desirable for patients, there is also the question of cost. Herceptin is not a cheap treatment: the list price of the treatment is £1222.20 per 600mg dose.

Herceptin has been a cornerstone of sales for Roche for a number of years and it brought in $7 billion in global sales alone in 2017.

Biosimilars are poised to make a significant dent into those sales but these findings should allow national bodies to apply the same principle to biosimilars – further reducing the cost of treatment. Though, as mentioned by Earl, more research will be needed analyse if there were any patient groups that did not perform as well under the six month cycle.

Ben Hargreaves

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