7 September 2020

The Scottish Medicines Consortium (SMC) has today (7 September 2020) approved Perjeta – given in combination with trastuzumab and chemotherapy – for routine use on Scotland’s NHS as a new treatment option after surgery for some patients with early breast cancer, to help further reduce the risk of recurrence or spread to other parts of the body.

A clinical trial [APHINITY] found that adding Perjeta (pertuzumab, Roche) to trastuzumab and docetaxel improved six-year invasive disease-free survival by 4.5% in patients whose breast cancers were HER2-positive and had spread to the lymph nodes, with a higher risk of their disease returning.

The evidence suggests that 87.9% of patients taking the triple combination were free of invasive disease after six years, compared to 83.4% of those who were treated with trastuzumab and docetaxel.

Around a quarter of patients diagnosed with HER2-positive breast cancer experience a recurrence within 10 years.

Perjeta as an adjuvant treatment was previously rejected by the SMC in October 2019. According to the SMC, this was because it was not found to be a cost-effective use of NHS resources. It is estimated around 200 patients each year in Scotland will now be eligible to benefit from adjuvant Perjeta after their surgery. This treatment combination is already available in England, Northern Ireland and Wales. 

The SMC has already approved Perjeta for routine use on the NHS in two other patient groups - before surgery in patients with primary breast cancer (December 2018), and as a first-line treatment for patients with secondary (metastatic) breast cancer (January 2019).

Baroness Delyth Morgan, Chief Executive at Breast Cancer Now, the research and care charity, said:

“We’re delighted that certain patients with early breast cancer in Scotland will now be able to benefit from this promising treatment combination after surgery on the NHS – today’s decision means there is now equal access to the treatment across the UK.

“The fear of breast cancer returning or spreading to other parts of their body can cause huge anxiety for so many women, and it’s a positive step forward that adding Perjeta to trastuzumab and chemotherapy can offer more women the chance to further reduce their risk of recurrence.

“Trastuzumab has been one of the greatest advances in treating breast cancer in recent decades. Continuing incremental developments, like adjuvant Perjeta, are absolutely vital to reaching our vision that by 2050, everyone who develops breast cancer will live – and live well.

“It’s now crucial that clinicians discuss this new treatment option and its risks and benefits with any eligible patients, giving them the information and support they need to make the decision that is right for them.”