Original Title: Trastuzumab con pertuzumab en cáncer de mama HER2 positivo

Authors' recommendations: Moderate-quality evidence shows that adding pertuzumab to neoadjuvant therapy with trastuzumab and chemotherapy in patients with HER2-positive breast cancer results in a considerable net benefit since it prolongs relapse-free survival and increases the likelihood of attaining complete disease remission. Low-quality evidence suggests that adding pertuzumab to treatment with trastuzumab and chemotherapy in the context of adjuvancy may result in a considerable net benefit since it increases invasive-disease-free survival. High-quality evidence shows that adding pertuzumab to treatment with trastuzumab and chemotherapy in patients with HER2-positive metastatic breast cancer is associated to a higher benefit since it prolongs overall survival. Low-quality evidence suggests that replacing trastuzumab in its original presentation with CT-P6 or SB3 biosimilars along with pertuzumab and chemotherapy may result in a net benefit similar to using the original drug as neoadjuvant therapy and in patients with HER2-positive metastatic breast cancer. Clinical practice guidelines from the United States, the United Kingdom and Europe recommend adding pertuzumab to trastuzumab and chemotherapy both in neoadjuvancy and adjuvancy and in metastatic disease treatment. The public health systems from the United Kingdom and Australia cover the indication of pertuzumab as neoadjuvancy, adjuvancy and in patients with metastatic breast cancer, whereas the French public system only covers it in the last two scenarios mentioned. The Canadian public system does not cover adding pertuzumab in any of the three scenarios. In the United States, the public system does not offer direct coverage of this drug, while the private health funders Aetna, Anthem and Cigna cover its indication in neoadjuvancy, adjuvancy and metastatic cancer. Brazil’s National Health Agency does not mention this drug; however, the CONITEC issued a favorable report for its inclusion in patients with metastasis. In Argentina, its indication as neoadjuvant therapy and in patients with metastatic cancer is covered by the Unique System of Reimbursements. One economic evaluation carried out in Argentina considers that indicating pertuzumab is not cost-effective for the treatment of HER2-positive metastatic breast cancer from the public health system perspective. No economic evaluations carried out in Argentina of pertuzumab in the context of neoadjuvant or adjuvant therapy have been found. Ecoevaluations carried out in the United Kingdom and Portugal determined that its indication is not cost-effective in those countries; while one evaluation carried out in Canada considered that uncertainty is too high to issue an opinion on this matter.

Project Status: Completed

Year Published: 2022

URL for published report: https://www.iecs.org.ar/publicacion/?id=22255

English language abstract: An English language summary is available

Publication Type: Full HTA

Country: Argentina

Organisation Name: Institute for Clinical Effectiveness and Health Policy

Contact Address: Dr. Emilio Ravignani 2024, Buenos Aires - Argentina, C1414 CABA

Contact Name: info@iecs.org.ar

Contact Email: info@iecs.org.ar

Copyright: Institute for Clinical Effectiveness and Health Policy (IECS)