A new report from research and consulting
firm GlobalData says that the United States treatment market for human
epidermal growth factor receptor type 2 (HER2) - positive breast cancer will
rise more than threefold in value, from $2.41 billion in 2013 to $7.95 billion
Of eight major countries, the US, France,
Germany, Italy, Spain, the UK, Japan and China, the US HER2-positive breast cancer
market will develop the most, representing an striking Compound Annual Growth
Rate (CAGR) of 12.7%, the report states.
"The rising incidence of HER2-positive
in the US,
along with the significant use of high-priced HER2-targeting therapies in all
phases of the disease, particularly the neoadjuvant and adjuvant settings, has
boosted sales of these drugs in the country. The adjuvant treatment sales would
undergo the highest growth, from $1.25 billion in 2013 to $5.44 billion by
2023, representing a rise in market share from 52% to 69%. The neoadjuvant
market share will remain steady at just 5% during this period." Jamie
Mallinson, Ph.D., GlobalData's Analyst covering
GlobalData observes that the US Affordable
Care Act would be another driving factor behind the overall market expansion,
as a higher number of patients would be eligible for treatment with more
The report says that herceptin is the
United States' market-leading HER2-positive breast cancer treatment, with
tremendous revenues of over $1.83 billion in 2013, accounting for a significant
However, GlobalData expects its sales to
decrease at a negative Compound Annual Growth Rate (CAGR) of 4.4% by the end of
2023. (CAGR is a business and investing specific term for the geometric
progression ratio that gives a constant rate of return over the time period).
"Herceptin's decline will be due largely to
its US patent expiration in 2019 and the rapidly developing market shares of
Roche's two latest biologics, Perjeta and Kadcyla, which will see their
revenues rise at respective CAGRs of 27.9% and 30.9%," Jamie Mallinson
Additional barriers to market growth
include the use of HER2-targeting biologics in the early lines of
GlobalData believes will limit the entry of new agents during the forecast
period. Increasing cost awareness in public healthcare spending could also impact
on payer reimbursement for drugs covered under Medicare Part D, which include
all of the branded HER2-positive therapies.
"These factors may encourage oncologists to
recommend alternatives to the more high-priced HER2-targeting therapies,
further hindering market expansion," the analyst concludes.
HER2-positive breast cancer
HER2-positive breast cancers tend to be
more destructive than other types. They're also less reactive to
. Standard chemotherapy
agents such as doxorubicin (Adriamycin) can be effective in treating the breast
cancer, although these medications don't specifically target the HER2 protein.
Routine testing for HER2 is suggested for
most women diagnosed with invasive breast cancer because the results may affect
treatment decisions. HER2 testing is not done routinely for
(the most common type of
non-invasive breast cancer
) but may be
performed as part of a clinical trial.
Whenever breast cancer recurs, the cancer
cells should be re-examined for HER2 as well as for hormone receptor status, as
these can change from the original cancer in up to 20 to 30 percent of cases.
However, treatments that specifically
target HER2 include:
, which specifically targets HER2, kills these
decreases the risk of re-emergence. It is often used with chemotherapy. It may
also be used alone and in combination with hormone-preventing medications, such
as an aromatase inhibitor or tamoxifen.
is a HER2-specific drug.
is effective for HER2-positive
breast cancer that doesn't respond to trastuzumab. The drug is used in
combination with the chemotherapy drug capecitabine (Xeloda) and the aromatase
inhibitor letrozole (Femara). Lapatinib is also being studied in combination