The HER2-positive breast cancer treatment paradigm has undergone considerable change in recent years and is expected to evolve further as more novel therapies enter the market. The enthusiastic adoption of HER2-targeting biologics, Roche/Genentech’s Perjeta (pertuzumab) and Kadcyla (T-DM1), has increased the barrier of entry for new emerging therapies. However, unmet need still exists for the treatment of advanced/metastatic HER2-positive breast cancer. Our content examines the key drivers of prescribing and analyzes the areas of significant commercial opportunities.

Questions Answered:

  • What are the treatment drivers and goals for advanced/metastatic HER2-positive breast cancer?
  • What attributes are key influencers, which have limited impact, and which are hidden opportunities?
  • How do current therapies perform on key treatment drivers and goals for advanced/metastatic HER2-positive breast cancer?
  • What are the prevailing areas of unmet need and opportunity in advanced/metastatic HER2-positive breast cancer?
  • What trade-offs across different clinical attributes and price are acceptable to U.S. and European medical oncologists for a hypothetical new, advanced/metastatic HER2-positive breast cancer drug?

Markets covered: United States, United Kingdom, France, Germany

Primary research: Survey of 60 U.S. and 31 European medical oncologists fielded in February 2017.

Key companies: Roche/Genentech, Novartis

Key drugs: Perjeta, Kadcyla, Tykerb/Tyverb

Table of contents

  • Breast Cancer - Unmet Need - Detailed, Expanded Analysis (US & EU): Advanced/Metastatic HER2-Positive Breast Cancer
    • Key Updates
      • December 2017
      • September 2017
      • May 2017
    • Treatment Drivers and Goals
      • Overview
      • Rationale for Treatment Drivers and Goals Selection
        • Efficacy
        • Safety and Tolerability
        • Convenience of Administration
      • Physician Rating of Treatment Drivers and Goals in Advanced/Metastatic HER2-Positive Breast Cancer
        • Importance of Efficacy Attributes to Prescribing Decisions in Advanced/Metastatic HER2-Positive Breast Cancer: United States
        • Importance of Efficacy Attributes to Prescribing Decisions in Advanced/Metastatic HER2-Positive Breast Cancer: Europe
        • Importance of Safety and Tolerability Attributes to Prescribing Decisions in Advanced/Metastatic HER2-Positive Breast Cancer: United States
        • Importance of Safety and Tolerability Attributes to Prescribing Decisions in Advanced/Metastatic HER2-Positive Breast Cancer: Europe
        • Importance of Convenience of Administration Attributes to Prescribing Decisions in Advanced/Metastatic HER2-Positive Breast Cancer: United States
        • Importance of Convenience of Administration Attributes to Prescribing Decisions in Advanced/Metastatic HER2-Positive Breast Cancer: Europe
      • Stated vs. Derived Importance of Treatment Drivers and Goals
        • Stated vs. Derived Importance of Key Efficacy, Safety and Tolerability, Convenience of Administration, and Nonclinical Attributes to Prescribing Decisions in Advanced/Metastatic HER2-Positive Breast Cancer: United States
        • Stated vs. Derived Importance of Key Efficacy, Safety and Tolerability, Convenience of Administration, and Nonclinical Attributes to Prescribing Decisions in Advanced/Metastatic HER2-Positive Breast Cancer: Europe
    • Product Performance Against Treatment Drivers and Goals
      • Overview
      • Rationale for Drug Selection
        • Regimens for Advanced/Metastatic HER2-Positive Breast Cancer
      • Current Brand Performance on Key Treatment Drivers and Goals
        • Overall Performance of Key Therapies for Advanced/Metastatic HER2-Positive Breast Cancer: United States
        • Overall Performance of Key Therapies for Advanced/Metastatic HER2-Positive Breast Cancer: Europe
        • Relative Performance of Key Therapies for Advanced/Metastatic HER2-Positive Breast Cancer Across Select Efficacy Attributes: United States
        • Relative Performance of Key Therapies for Advanced/Metastatic HER2-Positive Breast Cancer Across Select Efficacy Attributes: Europe
        • Relative Performance of Key Therapies for Advanced/Metastatic HER2-Positive Breast Cancer Across Select Safety and Tolerability Attributes: United States
        • Relative Performance of Key Therapies for Advanced/Metastatic HER2-Positive Breast Cancer Across Select Safety and Tolerability Attributes: Europe
        • Relative Performance of Key Therapies for Advanced/Metastatic HER2-Positive Breast Cancer Across Select Convenience of Administration Attributes: United States
        • Relative Performance of Key Therapies for Advanced/Metastatic HER2-Positive Breast Cancer Across Select Convenience of Administration Attributes: Europe
    • Assessment of Unmet Need
      • Overview
      • Overall Satisfaction with Current Treatment
        • Surveyed Medical Oncologists’ Satisfaction with the Performance of Key Therapies for Advanced/Metastatic HER2-Positive Breast Cancer on Efficacy, Safety and Tolerability, Convenience of Administration, and Nonclinical Factors: United States
        • Surveyed Medical Oncologists’ Satisfaction with the Performance of Key Therapies for Advanced/Metastatic HER2-Positive Breast Cancer on Efficacy, Safety and Tolerability, Convenience of Administration, and Nonclinical Factors: Europe
      • Physician Rating of Unmet Need in Advanced/Metastatic HER2-Positive Breast Cancer
        • Surveyed Medical Oncologists' Ascribed Level of Unmet Need Across Key Efficacy Attributes in Advanced/Metastatic HER2-Positive Breast Cancer: United States
        • Surveyed Medical Oncologists' Ascribed Level of Unmet Need Across Key Efficacy Attributes in Advanced/Metastatic HER2-Positive Breast Cancer: Europe
        • Surveyed Medical Oncologists' Ascribed Level of Unmet Need Across Key Safety and Tolerability Attributes in Advanced/Metastatic HER2-Positive Breast Cancer: United States
        • Surveyed Medical Oncologists' Ascribed Level of Unmet Need Across Key Safety and Tolerability Attributes in Advanced/Metastatic HER2-Positive Breast Cancer: Europe
        • Surveyed Medical Oncologists' Ascribed Level of Unmet Need Across Key Convenience of Administration Attributes in Advanced/Metastatic HER2-Positive Breast Cancer: United States
        • Surveyed Medical Oncologists' Ascribed Level of Unmet Need Across Key Convenience of Administration Attributes in Advanced/Metastatic HER2-Positive Breast Cancer: Europe
      • Unmet Need in Advanced/Metastatic HER2-Positive Breast Cancer and Related Indications
        • Surveyed Medical Oncologists' Ascribed Level of Unmet Need in Advanced/Metastatic HER2-Positive Breast Cancer and Related Indications: United States
        • Surveyed Medical Oncologists' Ascribed Level of Unmet Need in Advanced/Metastatic HER2-Positive Breast Cancer and Related Indications: Europe
    • Opportunity Analysis
      • Areas of Opportunity in the Advanced/Metastatic HER2-Positive Breast Cancer Market and Emerging Therapy Insights
        • Opportunity: A New Therapy with Improved Efficacy Attributes
        • Opportunity: A New Agent with a Lower Incidence of Hematological and Gastrointestinal Toxicities
        • Opportunity: A New HER2-Targeting Agent with Reduced Cardiotoxicity
        • Opportunity: New Therapies with More-Convenient Routes of Administration
    • Target Product Profiles
      • Assessing Drug Development Opportunities
      • Target Product Profile Methodology
        • Attributes and Attribute Levels
      • Attribute Importance and Part-Worth Utilities
        • Advanced/Metastatic HER2-Positive Breast Cancer Target Product Profile: Attribute Importance
        • Median Overall Survival
        • Median Progression-Free Survival
        • Objective Response Rate
        • Incidence of Grade 3/4 Hematological Toxicities
        • Incidence of Grade 3/4 Gastrointestinal Toxcities
        • Route of Administration
        • Price per 21-Day Cycle
      • Conjoint Analysis-Based Simulations of Market Scenarios
        • Advanced/Metastatic HER2-Positive Breast Cancer Market Simulations: Share of Preference of Target Product Profiles Included in Scenario 1
        • Advanced/Metastatic HER2-Positive Breast Cancer Market Simulations: Likelihood to Prescribe Target Product Profiles Included in Scenario 1
        • Advanced/Metastatic HER2-Positive Breast Cancer Market Simulations: Target Product Profiles Included in Scenario 1
        • Advanced/Metastatic HER2-Positive Breast Cancer Market Simulations: Share of Preference of Target Product Profiles Included in Scenario 2
        • Advanced/Metastatic HER2-Positive Breast Cancer Market Simulations: Likelihood to Prescribe Target Product Profiles Included in Scenario 2
        • Advanced/Metastatic HER2-Positive Breast Cancer Market Simulations: Target Product Profiles Included in Scenario 2
        • Advanced/Metastatic HER2-Positive Breast Cancer Market Simulations: Share of Preference of Target Product Profiles Included in Scenario 3
        • Advanced/Metastatic HER2-Positive Breast Cancer Market Simulations: Likelihood to Prescribe Target Product Profiles Included in Scenario 3
        • Advanced/Metastatic HER2-Positive Breast Cancer Market Simulations: Target Product Profiles Included in Scenario 3
    • Appendix
      • Key Abbreviations
      • Experts Interviewed
      • Bibliography

Author(s): Amy Yip, PhD

Amy Yip, Ph.D., is a Business Insights Analyst in the oncology team at Decision Resources Group. Prior to joining DRG, Dr. Yip worked as an analyst at GlobalData where she worked on a number of disease reports within Healthcare and Pharmaceuticals, with a particular focus on oncology. Dr. Yip obtained her doctorate in molecular medicine at the Liggins Institute, University of Auckland, where she investigated the impact of aberrant neurotrophic factor expression on hormone signaling pathways in breast cancer cells. Dr. Yip also holds a BSc (Hons) degree, with first class honors in biomedical science, awarded by the University of Auckland, and has previously worked with Novartis in their New Zealand office.


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