Hoffmann-La Roche (Roche Canada) has completed negotiations with the pan-Canadian Pharmaceutical Alliance (pCPA) for Perjeta (pertuzumab for injection), used in combination with trastuzumab and chemotherapy as a neoadjuvant treatment for patients with HER2-positive, locally advanced, inflammatory or early-stage breast cancer.

The agreement, concluded recently, marks an important step toward making Perjeta available through Canadian public drug plans for eligible patients. The pCPA negotiates drug prices on behalf of Canada's provinces and territories, and the completion of negotiations allows the process to move toward provincial and territorial reimbursement decisions.

HER2-positive breast cancer accounts for approximately 10–20 percent of breast cancer cases in Canada and is associated with more aggressive disease and an increased risk of recurrence. Early treatment, before the cancer spreads, can play an important role in reducing the risk of the disease returning.

Perjeta is used in the neoadjuvant setting, meaning treatment is administered before surgery. The approach aims to shrink tumours and make them easier to remove surgically. A key treatment outcome is pathologic complete response (pCR), defined as the absence of invasive cancer in the breast and/or lymph nodes following neoadjuvant treatment. Achieving pCR can also help guide subsequent treatment decisions.

The latest agreement follows sustained advocacy from Canada's breast cancer community for broader public access to Perjeta in the neoadjuvant setting. Public drug programmes initiated a Non-Sponsored Reimbursement Review, following which Canada's Drug Agency issued a positive recommendation. 

Roche Canada said the completion of the negotiations establishes the foundation for the next stage of the reimbursement process. The company plans to work with provincial and territorial jurisdictions to advance individual reimbursement decisions and support the availability of Perjeta through public drug plans.

Perjeta is a targeted monoclonal antibody that binds to the HER2 protein on cancer cells. It is designed to prevent HER2 from pairing with other HER receptors, a process involved in tumour growth and survival.

When combined with trastuzumab, Perjeta targets a different site on the HER2 receptor. Together with chemotherapy, the two antibodies provide a dual blockade of HER2 signalling pathways in the neoadjuvant treatment setting.

Breast cancer is the most commonly diagnosed cancer among Canadian women and the second leading cause of cancer death. An estimated 32,400 new breast cancer cases and 5,400 deaths are expected in Canada in 2026. The disease predominantly affects women aged 50 to 69, with risk increasing with age.

Most breast cancers in Canada are diagnosed at an early stage, when treatment with curative intent can be pursued. HER2-positive breast cancer occurs when tumour cells produce excessive amounts of the HER2 protein, which normally helps regulate cell growth. Overexpression of the protein can cause cancer cells to grow and divide more rapidly.