Roche’s adjuvant treatment PBS listed in early breast cancer

Effective 1st April 2020, Roche’s Kadcyla is listed on the Pharmaceutical Benefits Scheme (PBS), for the adjuvant treatment of patients with HER2-positive early breast cancer (eBC) who have residual invasive disease after neoadjuvant taxane and trastuzumab-based treatment.

In the adjuvant setting, Kadcyla was found to have reduced disease recurrence by 50% (HR=0.50, 95% CI 0.39-0.64; p<0.001) in patients with HER2-positive early breast cancer, who had residual invasive disease following neoadjuvant taxane and trastuzumab-based treatment.

Associate Professor Elisabeth Elder, specialist breast surgeon and head of research at the Westmead Breast Cancer Institute said “As a surgeon and a member of the multidisciplinary team, the shared goal is to provide the patient with optimal treatment options and ultimately maximise success in eliminating the disease. Neoadjuvant therapy is a key part of ensuring that patients are not losing further treatment options like adjuvant Kadcyla.”

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Australian guidelines recommend that treatment of early breast cancer be provided by a multidisciplinary team, consisting of at least a surgeon, medical oncologist, radiation oncologist, radiologist and nurse, to ensure optimal patient outcomes.

As surgeons are often the first point of contact for breast cancer patients along the treatment journey, they play an important role in identifying patients who would benefit from neoadjuvant therapy.

Breast surgeon and Vice President of BreastSurgANZ, Dr. Melanie Walker further highlighted the advantages of neoadjuvant treatment in helping to improve patient outcomes by offering additional treatment options in the adjuvant setting.

“Neoadjuvant therapy can act as an in vivo model of disease that is important prognostically for assessing tumour response to treatment and allowing adaptation in post-surgery treatment to maximise patient outcomes. It is no longer simply a tool for improving surgical outcomes but a crucial part of the optimal treatment pathway,” said Dr. Walker.

According to international guidelines, neoadjuvant treatment should be considered for all appropriate patients, especially those with HER2-positive and triple-negative breast cancer, as part of optimal treatment planning.

According to medical oncologist, Dr Richard de Boer, from St Vincent’s Private Hospital Melbourne, “The changing algorithm of treatment in early breast cancer means we can offer patients with HER2-positive breast cancer better treatment options that can reduce the risk of disease recurrence – which is a significant cause of anxiety for breast cancer patients.”

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Breast cancer is the most common cancer affecting Australian women, with 1 in 7 women being diagnosed with breast cancer by the age of 85.8. In 2020, it is estimated that around 20,000 women and 170 men will be diagnosed with breast cancer.

HER2-positive cancer accounts for approximately 15-20% of breast cancer cases and is associated with a more aggressive form of the disease.

Roche Australia Managing Director Stuart Knight said “I congratulate the Federal Government on expediting the PBS listing of Kadcyla. Roche has a long heritage of innovation in breast cancer cancer, and I’m delighted that eligible patients now have an additional option for the adjuvant treatment of HER2-positive early breast cancer.”

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