Although in general great advancement has been made in the past years with regard to metastatic breast cancer treatment options, high unmet needs still exist for patients with triple negative disease and for patients who become refractory to current available treatment options targeting HER2, according to new global oncology research by GfK HealthCare.

Novel agents in development for these two groups of patients clearly dominated physicians? minds across all markets. In the United States and Europe almost one-third of physicians spontaneously mentioned their positive expectations around PARP inhibitors when asked about novel agents, although new clinical data published in early 2011 is expected to lead to a less optimistic view in the future. The new generation of antibodies targeting HER2, more specifically T-DM1 and pertuzumab, as well as Halaven, have also significantly gained awareness with oncologists around the world.

In the months preceding the FDA?s December 2010 recommendation to remove the breast cancer indication from the Avastin label, use of this drug in the treatment of metastatic breast cancer dropped significantly in the U.S. as well as in Europe, although to a lesser extent.The international study also revealed several notable country differences in approaches to breast cancer treatment, with the following highlights.

United States
The U.S. reported the sharpest drop in use of Bevacizumab (Avastin, Genentech/Roche), across all metastatic treatment lines and patient subtypes (use of first-line Bevacizumab for HER2-negative disease in the U.S. dropped from a 23% patient share in 2009 to just 13 percent in 2010). U.S. oncologists use Ixempra, which is neither approved in Europe nor in Japan, primarily from the third-line setting onward for both HER2-negative and HER2-positive metastatic disease with the highest patient share seen in fourth line (20%).

In Europe, the main five countries ? the UK, Germany, France, Italy and Spain ? reported a lower rate of adjuvant systemic treatment (Europe overall when compared with the U.S. and Japan), and the lowest rate of neo-adjuvant systemic treatment was seen in Italy, when compared with any other country analyzed. UK physicians less frequently use Tyverb in HER2-positive metastatic breast cancer when compared with colleagues from other countries (just an 8 percent patient share in the second-line setting).

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In Japan,patients diagnosed with metastatic disease aretreated more intensively than in the U.S. or Europe (35% get at least four metastatic treatment lines); Japanese physicians also reported the highest use of agents targeting HER2 in the fourth-line metastatic setting (83% patient share in HER2-positive disease). As seen for many other cancer indications, Japanese physicians are less aware of novel agents in clinical development for breast cancer when compared with colleagues from the U.S. and Europe.

A more conservative view
?The discussion on Avastin?s benefits vs. risks in metastatic breast cancer, initiated by the FDA last summer ? and the subsequent recommendation to remove the indication from its label ? might have important consequences in the way physicians will consider future therapies,? said Petra Maertens, director of oncology syndicated studies for GfK HealthCare. ?Looking forward, physicians may take a more conservative view when considering novel agents for first-line metastatic breast cancer and may, if trials have only shown a significant progression-free-survival advantage, wait for more conclusive overall-survival data.?More Than 550 Specialists Provide Insights Into Breast CancerReflecting insights from more than 550 oncologists, hematologists/oncologists and other specialists involved in the treatment of breast cancer (gynecologists and surgeons), including 174 from the U.S., 315 from Europe (UK, Germany, France, Italy, Spain) and 72 from Japan, fielded via Internet questionnaire in December 2010 to April 2011, GfK Research Matters? Breast Cancer Treatment Tracker provides analysis and insights into the breast cancer market from the perspective of treating specialists and gives answers to why physicians treat breast cancer patients the way they do.The study researches the dynamics of the current treatment of breast cancer, while also tracking the changing use and likely potential of different treatments and specific brands. GfK Research Matters has conducted similar studies in five other cancer indications, including non-small cell lung, colorectal, gastric and hormone refractory prostate cancer as well as malignant melanoma, with further cancer indications currently in development.About GfK HealthCare/GfK Research MattersGfK Research Matters is part of GfK HealthCare (, the largest provider of fully integrated custom health care marketing research in the world, offering the broadest range of custom and syndicated research offerings as well as innovative proprietary approaches to meet a product?s needs across its life cycle. GfK HealthCare is part of the Custom Research sector within the GfK Group (, which offers the fundamental knowledge that industry, retailers, services companies and the media need to make market decisions. GfK delivers a comprehensive range of information and consultancy services in the three business sectors of Custom Research, Retail and Technology and Media. The No. 4 market research organization worldwide operates in more than 100 countries and employs over 10,000 staff. In 2010, the GfK Group?s sales amounted to EUR 1.29 billion.CONTACT:GfK HealthCareJessica Makovsky, 1-267-304-3780VP Global

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