The European Medicines Agency's human medicines committee (CHMP) has recommended approval for Phesgo, Roche's innovative fixed-dose combination of two established breast cancer treatments - Herceptin (trastuzumab) and Perjeta (pertuzumab). This development marks a significant advancement in the treatment delivery for patients with HER2-positive breast cancer.
Innovative Drug Delivery Approach
The novel formulation combines two anti-HER2 therapies in a single-dose vial for subcutaneous administration, representing a substantial improvement over the current practice. Presently, patients receive Herceptin subcutaneously and Perjeta as an intravenous infusion separately. The new combination dramatically reduces administration time from over two hours for initial dosing to just eight minutes, with subsequent treatments taking approximately five minutes.
Clinical Applications and Patient Benefits
Phesgo has received CHMP's recommendation for multiple treatment scenarios in HER2-positive breast cancer:
- Early-stage breast cancer treatment (pre- and post-surgery)
- First-line therapy for metastatic breast cancer
- Combination therapy with chemotherapy
The subcutaneous administration offers particular advantages during the COVID-19 pandemic by reducing time spent in clinical settings. Furthermore, the possibility of at-home administration provides additional convenience for patients and healthcare providers.
Market Impact and Strategic Significance
This development comes at a crucial time for Roche as it faces increasing competition from biosimilars in its oncology portfolio. Despite market challenges, Perjeta has demonstrated remarkable growth, reaching CHF 2.9 billion ($3.2 billion) in the first nine months of 2020, while Herceptin sales declined 31% to CHF 3.1 billion due to biosimilar competition.
The APHINITY trial data supporting the combination's efficacy has shown improved disease-free survival in early-stage breast cancer when Perjeta is added to Herceptin. This clinical benefit, coupled with the more convenient administration format, positions Phesgo as a significant addition to Roche's product lineup.
Regulatory Status and Market Performance
Phesgo has already secured FDA approval and is available in the US market, where initial sales reached CHF 7 million as the company works to secure formulary approvals. The CHMP positive opinion typically precedes full EMA approval within weeks, suggesting imminent European market access.
This strategic move follows Roche's successful pattern of developing subcutaneous formulations to maintain market position in the face of biosimilar competition, as previously demonstrated with Herceptin and Rituxan. The company aims to replicate this success with Phesgo, particularly important as Perjeta's patent protection approaches expiration in the coming years.
