Most breasties haven’t heard the term biosimilar. Did you know, for example, that you may have another option when the cost of chemotherapy is too high or a specific treatment side effect becomes debilitating?
Over the past few years, more and more breasties have been receiving biosimilars during treatment. But many breasties, like Martha Carlson, are “not prepared to be sitting in the chair and suddenly receiving a biosimilar without a conversation ahead of time.”
Here’s everything you need to know about biosimilars and why they matter in breast cancer treatment:
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What are biosimilars?
Biosimilars weren’t widely made or used until after the Biologics Price Competition and Innovation Act was passed as part of the Affordable Care Act in 2010. Even then, biosimilars have only begun to reach patients in the last few years.
Erika Brown, PharmD, BCOP—a Senior Clinical Pharmacy Specialist in hematology and oncology at Houston Methodist Willowbrook Hospital—usually explains biosimilars by way of generics.
When you reach for acetaminophen at the store, you can choose between Tylenol or the generic store brand. In fact, most over-the-counter drugs have a brand name and a generic (Advil brand ibuprofen, Benadryl brand diphenhydramine, Tums brand antacid). Whatever your personal preference, both the brand name and the generic option work the same way and are equally effective.
But generics deal with small and structurally simple drugs to reproduce. They aren’t as complicated as the large, complex proteins that make up cancer drugs like chemotherapy.
These larger medications are called biologics because they are made from living cells (rather than chemicals). When a biologic is reproduced, it isn’t identical to the original drug (called the parent or reference drug), even though it has the same structure and the same mechanisms. Instead, it’s called biosimilar.
Biosimilars still need to be approved by the FDA for safety and effectiveness before they can be used in patients. The heavily regulated, rigorous FDA process ensures that if a biosimilar doesn’t work as well or is less safe than the parent drug, it won’t get approved. As of 2021, there are a handful of biosimilars that have already been approved by the FDA for breast cancer treatment.
Examples of common biosimilars in breast cancer treatment
1. Trastuzumab/Herceptin and its five biosimilars
Trastuzumab (brand name Herceptin) is a chemotherapy drug commonly used to treat HER2+ breast cancers. The most recent—Amgen’s trastuzumab biosimilar—was approved by the FDA in 2019.
2. Filgrastim/Neupogen and its three biosimilars
Filgrastim (brand name Neupogen) stimulates bone marrow to make more white blood cells in order to better fight infection after a round of chemotherapy.
3. Pegfilgrastim/Neulasta and its four biosimilars
Pegfilgrastim (brand name Neulasta) serves the same infection-fighting purpose as Filgrastim, but has a longer duration.
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What breasties need to know about biosimilars…
Biosimilars were created in order to improve access to valuable medicines and targeted therapies. They are also produced to give patients options!
Your treatment plan should always be made in tandem with your doctor. When deciding on a treatment plan, it’s important to know your options and advocate for yourself. And that’s exactly what biosimilars are—another option in your arsenal. There are a few things to consider if you or your doctor are thinking about a biosimilar:
- Biosimilars can be less expensive because a robust market for a drug type drives down the cost.
- Biosimilars can have different and sometimes fewer side effects than the parent drug. If you’re struggling with a debilitating side effect in your treatment, you should talk to your doctor about trying out a biosimilar.
- If you do switch to a biosimilar, your treatment might be a little longer for the first few appointments. Most doctors increase a patient’s observation time after administering a biosimilar (the amount of time you have to stay there after treatment) because there is a small risk of immunogenicity or an adverse immune reaction.
For more information, talk to your doctor about biosimilars and whether or not they might be an option for you.