On 14 September 2023, the Committee for Medicinal Products for Human Use (CHMP) adopted a positive opinion, recommending the granting of a marketing authorisation for the medicinal product Herwenda, intended for the treatment of HER2-positive breast and gastric cancer. The applicant for this medicinal product is Sandoz GmbH.
Herwenda will be available as a 150 mg powder for concentrate for solution for infusion. The active substance of Herwenda is trastuzumab, a HER2 inhibitor (ATC code: L01FD01) that binds with high affinity and specificity to HER2, inhibiting proliferation of tumour cells that overexpress HER2.
Herwenda is a biosimilar medicinal product. It is highly similar to the reference product Herceptin (trastuzumab), which was authorised in the EU on 28 August 2000. Data show that Herwenda has comparable quality, safety and efficacy to Herceptin. More information on biosimilar medicines can be found here.
The full indication is:
Metastatic breast cancer
Herwenda is indicated for the treatment of adult patients with human epidermal growth factor receptor 2 (HER2) positive metastatic breast cancer (MBC):
- as monotherapy for the treatment of those patients who have received at least two chemotherapy regimens for their metastatic disease. Prior chemotherapy must have included at least an anthracycline and a taxane unless patients are unsuitable for these treatments. Hormone receptor positive patients must also have failed hormonal therapy, unless patients are unsuitable for these treatments.
- in combination with paclitaxel for the treatment of those patients who have not received chemotherapy for their metastatic disease and for whom an anthracycline is not suitable.
- in combination with docetaxel for the treatment of those patients who have not received chemotherapy for their metastatic disease.
- in combination with an aromatase inhibitor for the treatment of postmenopausal patients with hormone receptor positive MBC, not previously treated with trastuzumab.
Early breast cancer
Herwenda is indicated for the treatment of adult patients with HER2 positive early breast cancer (EBC):
- following surgery, chemotherapy (neoadjuvant or adjuvant) and radiotherapy (if applicable) (see section 5.1).
- following adjuvant chemotherapy with doxorubicin and cyclophosphamide, in combination with paclitaxel or docetaxel.
- in combination with adjuvant chemotherapy consisting of docetaxel and carboplatin.
- in combination with neoadjuvant chemotherapy followed by adjuvant Herwenda therapy, for locally advanced (including inflammatory) disease or tumours > 2 cm in diameter (see sections 4.4 and 5.1).
Herwenda should only be used in patients with metastatic or EBC whose tumours have either HER2 overexpression or HER2 gene amplification as determined by an accurate and validated assay (see sections 4.4 and 5.1).
Metastatic gastric cancer
Herwenda in combination with capecitabine or 5 fluorouracil (5 FU) and cisplatin is indicated for the treatment of adult patients with HER2 positive metastatic adenocarcinoma of the stomach or gastro esophageal junction who have not received prior anti cancer treatment for their metastatic disease.
Herwenda should only be used in patients with metastatic gastric cancer (MGC) whose tumours have HER2 overexpression as defined by immunohistochemistry staining intensity of 2+ (IHC2+) and a confirmatory silver in situ hybridisation (SISH) or fluorescence in situ hybridisation (FISH) result, or by an IHC3+ result. Accurate and validated assay methods should be used (see sections 4.4 and 5.1).
Herwenda treatment should only be initiated by a physician experienced in the administration of cytotoxic chemotherapy and should be administered by a healthcare professional only.
Detailed recommendations for the use of this product will be described in the summary of product characteristics (SmPC), which will be published in the European public assessment report (EPAR) and made available in all official European Union languages after the marketing authorisation has been granted by the European Commission.
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