Access to Perjeta for Scottish breast cancer patients

A woman undergoing a breast appointment to show NICE recommends pertuzumab

Perjeta has been approved for Scottish breast cancer patients by the Scottish Medicines Consortium (SMC). SMC has recommended that Perjeta® (pertuzumab) should be made available to HER2-positive early breast cancer patients before surgery, also known as the neoadjuvant setting. This means that people in Scotland living with HER2-positive, locally advanced, inflammatory or early stage breast cancer at high risk of recurrence can benefit from Perjeta, in combination with trastuzumab and chemotherapy, on the NHS.

An estimated 415 patients per year in Scotland could be eligible to receive Perjeta in the neoadjuvant setting.

Perjeta has been shown to be an effective neoadjuvant treatment in HER2-positive early breast cancer. In the NeoSphere study involving 417 patients, the primary endpoint was pathological complete response (pCR) in the breast, the number of women whose tumours disappeared from the breast. Patients given Perjeta and trastuzumab plus docetaxel had a significantly improved pCR rate (49 of 107 patients; 45·8% [95% CI 36·1–55·7]) compared with those given trastuzumab plus docetaxel (31 of 107; 29·0% [20·6–38·5]; p=0·0141). 23 of 96 (24·0% [15·8–33·7]) women given Perjeta plus docetaxel had a pCR, as did 18 of 107 (16·8% [10·3–25·3]) given Perjeta and trastuzumab. The combination of Perjeta with trastuzumab and docetaxel did not result in any additional safety signals.

Richard Erwin, Roche’s General Manager said: “We’re delighted by this news, which is the result of a successful collaboration between Roche and SMC. Roche will now work closely with SMC to enable patient access to Perjeta in its other licensed indications. These include metastatic breast cancer, for patients where the cancer has spread to other parts of the body and in the adjuvant setting, which is when treatment is given for early breast cancer following surgery. We will continue to work in partnership to ensure all eligible patients in Scotland have access to the latest breast cancer treatments on the NHS.”

Dr Iain Macpherson, Consultant Medical Oncologist at The Beatson Cancer Centre in Glasgow said: “We often treat patients with HER2-positive early breast cancer with a course of chemotherapy and trastuzumab to shrink their cancer before they have surgery. By adding Perjeta, we increase the chances of eliminating the cancer in the breast and we know that this is associated with good long-term outcomes. This is a positive development for patients with breast cancer in Scotland.”