Despite the number of therapy options available, advanced or metastatic HR-positive / HER2-negative breast cancer remains incurable and a major cause of mortality and morbidity in women. Later-line therapies that can be used following the development of hormone resistance are greatly needed. Although the recent introduction of targeted therapies such as Piqray (Novartis) have improved patient outcomes, several treatment gaps remain. Emerging therapies such as elacestrant (Radius Health) and sacituzumab govitecan (Immunomedics) are poised to launch in the near term, boosting competition in an already crowded market. As this competition intensifies, novel therapies should address the remaining unmet needs in the treatment of advanced or metastatic HR-positive / HER2-negative breast cancer to differentiate themselves from their rivals.


  • What treatment drivers and goals are most likely to influence the choice of therapy for advanced or metastatic HR-positive/HER2-negative breast cancer?
  • How do key current therapies, such as Ibrance (Pfizer) and Piqray (Novartis), perform on key clinical attributes for this patient population?
  • What are the prevailing areas of unmet need and hidden opportunities in this patient population?
  • What trade-offs across different clinical attributes and price are acceptable to U.S. and European medical oncologists for a hypothetical therapy in advanced or metastatic HR-positive/HER2-negative breast cancer?


Unmet Need supports clinical development decisions by identifying key attributes and assessing areas of unmet need for a specific disease or subpopulation. Based on surveys with U.S. and European physicians, this report provides insight into key treatment drivers and goals, the performance of current therapies, and the remaining commercial opportunities. One market scenario is profiled in detail by DRG experts, and additional customized market scenarios can be evaluated with the corresponding TPP simulator.

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

Primary research: Survey of 60 U.S. and 30 European medical oncologists fielded in February 2020.

Key companies: Onyx Pharmaxeauticals / Pfizer, Novartis, Eli Lilly, AstraZeneca, Abbott Laboratories.

Key drugs: Ibrance, Kisqali, Verzenio, Piqray, Faslodex, Afinitor, letrozole, anastrozole, and exemestane.

Table of contents

  • Breast Cancer - Unmet Need - Detailed, Expanded Analysis (US & EU ) Metastatic HR-Positive/ HER2-Negative

Author(s): Sorcha Cassidy M.Res., Ph.D

Sorcha Cassidy M.Res., Ph.D., is an Associate Director in the Oncology team at Decision Resources Group.  Dr. Cassidy manages a team of analysts who conduct extensive primary and secondary market research on several Oncology indications across the major pharmaceutical markets. She also provides sales and client support across all oncology products. She has in-depth expertise in competitive intelligence, secondary and primary market research, and delivering strategic insights that address key client business questions. Dr. Cassidy holds an M.Res and Ph.D in Immunology from Imperial College London where she investigated the role of innate immune modulators (killer immunoglobulin-like receptors [KIR) on natural killer (NK) cells in various diseases and published several peer-reviewed papers. Prior to joining the company, Dr. Cassidy previously worked as a Market Research Manager in Janssen UK and has extensive experience working across multiple Oncology indications at GlobalData and FirstWord Pharma.

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