Therapy Trends KOL Insight: Breast Cancer [2019]

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Publication Date:
May 2019
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What impact will the Kadcyla KATHERINE study have?

KOLs discuss how the Phase III KATHERINE study with Roche’s Kadcyla is expected to change current treatment practice. Experts also give their views on pipeline agents that could disrupt the current HER2-positive treatment paradigm, such as Daiichi Sankyo/AstraZeneca’s trastuzumab deruxtecan and MacroGenics’ margetuximab. In the HER2-negative/HR-positive space, experts provide insights on Pfizer’s CDK4/6 inhibitor, Ibrance, and whether Novartis’ Kisqali and Eli Lilly’s Verzenio are succeeding in taking a slice of the market. KOLs speculate on alpelisib’s SOLAR-1 data and how this agent could be positioned in the HER2-negative/HR-positive space. AstraZeneca/Merck & Co.’s Lynparza and Pfizer’s Talzenna are discussed as therapies for BRCA-mutated triple-negative breast cancer, while KOLs give their views on the recent launch of Roche’s Tecentriq, as well as pipeline agents such as Immunomedics’ sacituzumab govitecan and Roche’s ipatasertib. 

Twelve US and EU KOLs offer their candid insights on these issues and more.

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Top takeaways

  • Results from the Kadcyla Phase III KATHERINE study have been reported. How do KOLs perceive these results and to what extent will they impact prescribing?
  • Daiichi Sankyo has signed an agreement with AstraZeneca for trastuzumab deruxtecan. How do KOLs view this product and where is it expected to be positioned?
  • Novartis’ Afinitor prescribing has been decreasing since CDK4/6 inhibitors entered the market. What trial could potentially give Afinitor a new lease of life?
  • How successful have the Kisqali and Verzenio launches been? And can Pfizer’s Ibrance retain its position as the preferred CDK4/6 inhibitor?
  • How could the alpha specific PI3 kinase inhibitor, alpelisib be positioned in the treatment paradigm? KOLs offer their views on this agent, as well as the Phase III SOLAR-1 data.
  • Lynparza, Talzenna and Tecentriq are available as therapies for triple-negative breast cancer (TNBC). How are these products currently being prescribed and how will usage evolve in the future?
  • KOLs discuss how late-stage pipeline agents may be used in TNBC. What are KOLs’ thoughts on sacituzumab govitecan, ipatasertib and adagloxad simolenin and how do they envisage these products being used in the future?
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“In the high-risk patient population in the PALLAS trial, the stage 2 and 3 patients, I do anticipate that there is going to be a disease-free survival benefit. These therapies are very effective in the metastatic setting and I anticipate that they’ll probably be filling the activity in a high-risk patient population in the adjuvant setting…”

US Key Opinion Leader

Alpelisib has good data. We have seen the results from one randomised clinical trial in patients with PI3-kinase mutation where the results are quite clear in terms of a PFS benefit.”

EU Key Opinion Leader

Sample of therapies covered

Marketed Therapies

  • Herceptin (trastuzumab; Roche)
  • Kadcyla (ado-trastuzumab emtansine; Roche)
  • Perjeta (pertuzumab; Roche)
  • Tykerb/Tyverb (lapatinib; Novartis)
  • Nerlynx (neratinib; Puma Biotechnology/Pierre Fabre)
  • Afinitor (everolimus; Novartis)
  • Ibrance (palbociclib; Pfizer)
  • Kisqali (ribociclib; Novartis)
  • Verzenio (abemaciclib; Eli Lilly)
  • Lynparza (olaparib; AstraZeneca/Merck & Co.)
  • Talzenna (talazoparib; Pfizer)
  • Tecentriq (atezolizumab; Roche)

Pipeline Therapies

  • margetuximab (MGAH 22; MacroGenics)
  • trastuzumab deruxtecan (Daiichi Sankyo/AstraZeneca)
  • trastuzumab duocarmazine (Synthon)
  • alpelisib (BYL 719; Novartis)
  • entinostat (SNDX 275; Syndax)
  • Zejula (niraparib; Tesaro/Merck & Co.)
  • veliparib (ABT 888; AbbVie)
  • Keytruda (pembrolizumab; Merck & Co.)
  • Bavencio (avelumab; Merck Group/Pfizer)
  • ipatasertib (GDC 0068; RG 7440; Roche)
  • sacituzumab govitecan (IMMU-132; Immunomedics)
  • adagloxad simolenin (OBI 822; OBI Pharma)

KOLs interviewed

KOLs from North America

  • Dr Adam M. Brufsky, MD, PhD, FACP is Professor of Medicine at the University of Pittsburgh School of Medicine, Pittsburgh, PA
  • Dr Dawn L. Hershman, MD, MS is Professor of Medicine and Epidemiology, Leader, Breast Cancer Program, Herbert Irving Comprehensive Cancer Center, Columbia University, New York, NY
  • Dr Reshma Mahtani, DO is Assistant Professor of Clinical Medicine, Division of Hematology/Oncology, Miller School of Medicine, University of Miami, FL
  • Dr Lajos Pusztai, MD, DPhil is Professor of Medicine at Yale University and Director of Breast Cancer Translational Research and Co-Director of the Cancer Center Genomics, Genetics, and Epigenetics Program, New Haven, CT
  • Dr Charles L. Vogel, MD is Professor of Clinical Medicine, Division of Hematology/Oncology, Miller School of Medicine, University of Miami, FL
  • Anonymous, US KOL is a medical oncologist at a leading US cancer institute.

KOLs from Europe

  • Dr Giuseppe Aprile, MD is Director of the Department of Structural Clinical Oncology Vicenza, Director of Oncology, Ospedale San Bortolo di Vicenza, Vicenza, Italy
  • Dr Thomas Bachelot, MD is Head of the Breast Cancer Unit and the Clinical Trial Unit at the Centre Léon Bérard, Lyon, France
  • Dr Richard Baird, MA, MBBS, PhD, FRCP is Academic Consultant in Experimental Cancer Therapeutics, University of Cambridge and Honorary Consultant in Medical Oncology, Addenbrooke’s Hospital, Cambridge, UK
  • Dr Adrian L. Harris, MD, DPhil is Professor of Medical Oncology at the University of Oxford and Director of the Cancer Research UK Medical Oncology Unit, London, UK
  • Anonymous, German KOL is a professor and consultant of oncology at a leading German university hospital
  • Anonymous, German KOL is deputy director of a clinic at a leading German university hospital

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