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The breast cancer market

Nature Reviews Drug Discovery volume 14, pages 233–234 (2015)Cite this article

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Current treatments

The HER2-positive disease subtype currently occupies the largest share of the BC drug market. The HER2-specific monoclonal antibody (mAb) trastuzumab (Herceptin; Roche) was launched in the United States in 1998 and, in combination with taxane chemotherapy, this drug has greatly improved prognosis for HER2-positive patients. In 2012, a second mAb, pertuzumab (Perjeta; Roche), was released; this drug works synergistically with trastuzumab when the two are co-administered. In 2013, ado-trastuzumab emtansine (Kadcyla; Roche), an antibody–drug conjugate (ADC) that uses the trastuzumab mAb to deliver a potent chemotoxin directly to tumour tissues, entered the market. With these newer drugs, the HER2 franchise is bolstered against competition — the European patents for trastuzumab expire in 2014–2015, and several companies are lining up biosimilars: most prominently, Celltrion and Hospira, who have gained approval for their version in Korea, and Mylan, which has a biosimilar approved in India. The challenge for Roche is to show that its new, premium-priced drugs can substantially improve on trastuzumab's clinical effectiveness in as many lines of therapy as possible. Pertuzumab has already largely succeeded in this: in combination with trastuzumab and docetaxel, it showed a 15.7-month improvement in overall survival compared with placebo plus trastuzumab and docetaxel as first-line therapy for metastatic disease. It is already approved in the United States as a neoadjuvant treatment for reducing tumour bulk prior to surgery. Another trial (called APHINITY) is ongoing to assess whether pertuzumab can improve progression-free survival as a post-surgery adjuvant, an indication for which a 1-year course of trastuzumab is the current standard of care. For ado-trastuzumab emtansine, the clinical trial picture is, so far, less clear. It is approved as a second- and later-line of therapy for metastatic disease, but the MARIANNE trial failed to show any clinical benefit for the drug versus pertuzumab in first-line treatment.

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Figure 1: Market potential for products for breast cancer, in 2014 and forecast for 2019.

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  1. IMS Health Ltd, 210 Pentonville Road, London, N1 9JY, UK

    Basharut A. Syed

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  1. Basharut A. Syed
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Correspondence to Basharut A. Syed.

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The author declares no competing financial interests.

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Syed, B. The breast cancer market. Nat Rev Drug Discov 14, 233–234 (2015). https://doi.org/10.1038/nrd4571

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