script.reportAU
Oncology

Trastuzumab; pertuzumab; trastuzumab emtansine

Brand: Herceptin; Perjeta; Kadcyla

PBAC's latest decision on Trastuzumab; pertuzumab; trastuzumab emtansine: Recommended with restriction (2014). Considered for Trastuzumab: first-line and second/later-line treatment of HER2-positive metastatic breast cancer. Pertuzumab: first-line treatment in combination with trastuzumab and docetaxel for HER2-positive metastatic breast cancer. Trastuzumab emtansine (T-DM1): second-line treatment for HER2-positive metastatic breast cancer previously treated with trastuzumab and a taxane.

PBAC outcome
Recommended with restriction
Authority Required
ICER (AUD/QALY)
$200k/QALY
Range: $45k/QALY–$200k/QALY
Submissions
1
first 2014
Submissions
1
2014 → 2014

Eligible population

Trastuzumab first-line: patients with HER2-positive metastatic breast cancer who have not received prior anti-HER2 therapy or chemotherapy for metastatic disease. Trastuzumab second/later-lines: patients with HER2-positive metastatic breast cancer whose disease has progressed despite prior trastuzumab therapy. Pertuzumab: patients with HER2-positive metastatic breast cancer who have not received prior anti-HER2 therapy or chemotherapy, performance status 0–1, in combination with trastuzumab and docetaxel. T-DM1: patients with HER2-positive metastatic breast cancer who have received prior trastuzumab and a taxane and whose disease has progressed.

Therapy area
Oncology
Line of therapy
First-line; Second-line; Later-line
Evidence base
RCT
Primary endpoint
OS
Pivotal trial size
2,143 patients
Key trials
M77001, GBG26, CLEOPATRA, EMILIA, Berghoff (2013)
Comparator
Trastuzumab first-line: docetaxel; Trastuzumab second/later-lines: capecitabine; Pertuzumab: trastuzumab + taxane; T-DM1: lapatinib + capecitabine
Economic model
CUA
ICER note
Multiple ICERs reported across different indications and comparators. Trastuzumab first-line: $45,000–$75,000/QALY. Trastuzumab later-lines: $105,000–$200,000/QALY (GBG 26) and $45,000–$75,000/LYG (Berghoff). T-DM1 ICER not numerically stated in public text (redacted).

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