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Is Pertuzumab An Effective Medication For Metastatic Breast Cancer?
Question: A case of 58 yr old diagnosed with Stage 4 Metastatic cancer of Breast.
AS PER THE ONCOLOGIST NOTES ON THE PRESCRIPTION:
A Left breast 5*5 cm mass palpable with axillary nodes, left upper limb swelling and warm.
METASTATIC BREAST CANCER, ER +ve, PR -ve and Heu2 3 +ve
Recommend NCCN guidelines
Palliative chemotherapy plus Targeted hormone therapy.
The local Medical Oncologist had recommended the following protocol.
The regimen recommended consisting of 6 cycles of: Transtuzumab, Pertuzumab, Docetaxel with Peg G-CSF support.
The cost of this regimen is estimated to be 25.5 Lacs.
However another doctor from same team has suggested a regimen with only Transtuzumab and Docetaxel that costs 6 to 7 lakhs (on the ground that the added benefit of Pertuzumbab is very little compared to its huge price)
Another opinion on which regimen should they go for?
How much is the added benefit of Pertuzumab compared to its cost?
AS PER THE ONCOLOGIST NOTES ON THE PRESCRIPTION:
A Left breast 5*5 cm mass palpable with axillary nodes, left upper limb swelling and warm.
METASTATIC BREAST CANCER, ER +ve, PR -ve and Heu2 3 +ve
Recommend NCCN guidelines
Palliative chemotherapy plus Targeted hormone therapy.
The local Medical Oncologist had recommended the following protocol.
The regimen recommended consisting of 6 cycles of: Transtuzumab, Pertuzumab, Docetaxel with Peg G-CSF support.
The cost of this regimen is estimated to be 25.5 Lacs.
However another doctor from same team has suggested a regimen with only Transtuzumab and Docetaxel that costs 6 to 7 lakhs (on the ground that the added benefit of Pertuzumbab is very little compared to its huge price)
Another opinion on which regimen should they go for?
How much is the added benefit of Pertuzumab compared to its cost?
Brief Answer:
Pertuzumab significant benefit in her2 positive metastatic breast cancer
Detailed Answer:
Hi
Thanks for your query.
Metastatic breast cancer is incurable disease but long term control is possible. You have not mentioned where all the disease has metastasized, lung, liver, bones, etc. That would help in prognostication.
Anyway, both the regimens are acceptable with pertuzumab containing regimen preferred. This is because, in phase III Cleopatra study, median survival of pertuzumab treated patients was 58 months as compared to 40 months in only trastuzumab treated patients. So difference is striking.
Cost is definitely an issue. And as you can understand, treatment will go on for patient's lifetime, in various permutations and combinations. So total cost is going to be huge.
Hope this helps.
Regards
Pertuzumab significant benefit in her2 positive metastatic breast cancer
Detailed Answer:
Hi
Thanks for your query.
Metastatic breast cancer is incurable disease but long term control is possible. You have not mentioned where all the disease has metastasized, lung, liver, bones, etc. That would help in prognostication.
Anyway, both the regimens are acceptable with pertuzumab containing regimen preferred. This is because, in phase III Cleopatra study, median survival of pertuzumab treated patients was 58 months as compared to 40 months in only trastuzumab treated patients. So difference is striking.
Cost is definitely an issue. And as you can understand, treatment will go on for patient's lifetime, in various permutations and combinations. So total cost is going to be huge.
Hope this helps.
Regards
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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