What’s the Good News for Our HER2-Positive Breasties?

In 1998, Genentech changed the landscape for breast cancer patients facing what was then one of the most aggressive sub-types of breast cancer, HER2-Positive.  It represents about 15%-20% of breast cancers.  Herceptin was a revolutionary treatment for breast cancer and gave hope and time to many patients. Herceptin works by blocking cancer cells from receiving chemical signals that spur growth. The data showed that, in combination with a type of chemotherapy, Herceptin cut the risk of people’s cancer coming back by half, compared to the chemo alone.

Another advancement was made in 2012 when Genentech launched Perjeta as the first-in-class drug that prevents cell growth and proliferation. Adding Perjeta and Herceptin to chemotherapy prolonged the time people with previously untreated HER2-positive metastatic breast cancer lived without their disease getting worse and helped them live longer overall. On average, the Herceptin/Perjeta combination extended the lives of those who received it by almost 16 months compared to Herceptin and chemotherapy alone. Patients lived a median of almost five years – the longest ever observed in people with this aggressive type of advanced breast cancer (56.5 months vs. 40.8 months). In 2013, Perjeta was approved for use in the early setting before surgery and subsequently in 2017 approved for to be used after surgery as well, for a total of 18 cycles or one year in patients who have a high likelihood of their cancer coming back.

Enter the Black Breast Cancer issue!  A 2015 study found that minority women, especially Black and American Indian/Alaskan Native women, were more likely to be diagnosed with more advanced stage breast cancer and also more likely to receive treatment below the standard of care than white women. This was validated in a study (Reeder-Hayes, K et. Al., J Clin Oncol 10.1200/JCO.2015.65.8716) published in 2016, that identified that Black women were 25% less likely to receive Herceptin than white women.   "This is significant because we know that there is a large number of women here who are not receiving a therapy that we know would give them a better chance of survival," said the study's first author Katherine Reeder-Hayes, M.D., MBA, clinical assistant professor at the University of North Carolina School of Medicine.

Why were Black women not given Herceptin when everyone knew it was the most effective treatment?  Several reasons were proposed, all of which are the typical health disparity statements.  Herceptin is routinely paired with other chemotherapy agents, and the administration is intense and demanding. The treatment schedule may have been impossible to keep for women who have unreliable transportation, job insecurity or poor social support.  Herceptin is also very expensive.  It costs about $5,000 per infusion, so women without supplemental Medicare insurance would have to pay about 20% of that amount out of pocket. Among these Medicare patients, Black women were less likely to have the supplemental insurance that would make treatment affordable. Lastly, Herceptin is given over a year. Research showed that black women were more likely to stop Herceptin before the year was up probably because they couldn’t afford it or keep up the intense schedule.

And of course, consistent with the devastating statistics for Black Breast Cancer (42% higher mortality rate than white women) many Black women with HER2-Positive breast cancer probably died unnecessarily because they didn't get this most effective treatment!

Fast forward to 2020! 

Genentech scientists do it again to enhance the lives of those with HER-2 positive Breast Cancer! Enter Phesgo, a combination with Perjeta and Herceptin that is administered in an under the skin injection in just minutes, compared to hours with the standard intravenous administration of Herceptin and Perjeta.  Research shows that 85% of patients prefer Phesgo compared to standard intravenous administration.

Phesgo is just a new combination of Perjeta and Herceptin.  It effectively prevents tumor cell growth and survival. The benefits are that the administration take approximately eight minutes for the initial dose and approximately five minutes for each subsequent maintenance dose. This is compared to approximately 150 minutes for the initial infusion of Perjeta and Herceptin, and between 60-150 minutes for subsequent maintenance infusions of the two medicines. Certain patients can have their Phesgo treatment at home by a healthcare professional if deemed safe by their doctor. 

All this to say that Black women with HER2-Positive breast cancer need to know about Phesgo!  We can’t let what happened with Herceptin happen again.  This is a revolutionary therapy that will save lives.  It will also enhance quality of life because of the time they will save from not having to get infusions. 

HER2-positive patient, Dr. Kordai DeCoteau, has been taking the Herceptin and Perjeta combination for 7 months. She is excited about Phesgo, “I am looking forward to replacing my 3 hour infusions with Phesgo so I can save time and navigate back into a more normal world, like everybody else. I would love not have to go to the hospital for infusions that limit my time and efficiency.”

Additionally, don’t let the cost stand in your way!  Genentech is committed to helping patients access their medicines regardless of their ability to pay via their Access Solutions department. Access Solutions is dedicated to helping people navigate the access and reimbursement process.  They provide assistance to eligible patients who are uninsured or cannot afford the out-of-pocket costs for their medicine. To date, they have helped more than 2 million patients access the medicines they need. You can contact them at (866) 4ACCESS/(866) 422-2377 or visit https://www.Genentech-Access.com for more information.

We appreciate Genentech’s commitment to advancing the science for HER2-Positive Breast Cancer. There should be no barriers to our Breasties having access to Phesgo. Ask your doctor about Phesgo. Let’s spread the buzz and enhance some lives. #BlackBreastCancerMatters

About TOUCH, The Black Breast Cancer Alliance

TOUCHBBCA was founded by survivor/thrivers Ricki Fairley and Valarie Clark Worthy who are passionate about doing the work to thoroughly understand Black Breast Cancer and lead the ecosystem toward eradicating it.  As a Stage 3A Triple Negative Breast Cancer Survivor/Thriver, Ricki’s personal purpose, passion, mission, ministry and blessing is to raise awareness, fundraise for a cure for breast cancer and support and coach what she calls her “Breasties”  through their breast cancer experience. She is a seasoned marketer who has focused her vast branding experience and strategic acumen to the breast cancer fight. Valarie Clark Worthy, a registered nurse with a master’s degree in Leadership: Community Health Systems has been a nurse for over 38 years. Patient Navigation, public, community and home infusion nursing summarizes her nursing career. Valarie, a 21-year breast cancer survivor understands the unique needs of cancer patients and their families. She works collaboratively with cancer centers around the nation to address the needs of African American women with breast cancer.  TOUCH, The Black Breast Cancer Alliance is a 501c3 organization. Learn more at touchbbca.org and follow on Facebook, Instagram, Twitter and YouTube @Touchbbca.