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Joshi D, Khursheed R, Gupta S, Wadhwa D, Singh TG, Sharma S, Porwal S, Gauniyal S, Vishwas S, Goyal S, Gupta G, Eri RD, Williams KA, Dua K, Singh SK. Biosimilars in Oncology: Latest Trends and Regulatory Status. Pharmaceutics 2022; 14:pharmaceutics14122721. [PMID: 36559215 PMCID: PMC9784530 DOI: 10.3390/pharmaceutics14122721] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 11/07/2022] [Accepted: 11/30/2022] [Indexed: 12/12/2022] Open
Abstract
Biologic-based medicines are used to treat a variety of diseases and account for around one-quarter of the worldwide pharmaceutical market. The use of biologic medications among cancer patients has resulted in substantial advancements in cancer treatment and supportive care. Biosimilar medications (or biosimilars) are very similar to the reference biologic drugs, although they are not identical. As patent protection for some of the most extensively used biologics begins to expire, biosimilars have the potential to enhance access and provide lower-cost options for cancer treatment. Initially, regulatory guidelines were set up in Europe in 2003, and the first biosimilar was approved in 2006 in Europe. Many countries, including the United States of America (USA), Canada, and Japan, have adopted Europe's worldwide regulatory framework. The use of numerous biosimilars in the treatment and supportive care of cancer has been approved and, indeed, the count is set to climb in the future around the world. However, there are many challenges associated with biosimilars, such as cost, immunogenicity, lack of awareness, extrapolation of indications, and interchangeability. The purpose of this review is to provide an insight into biosimilars, which include various options available for oncology, and the associated adverse events. We compare the regulatory guidelines for biosimilars across the world, and also present the latest trends and challenges in medical oncology both now and in the future, which will assist healthcare professionals, payers, and patients in making informed decisions, increasing the acceptance of biosimilars in clinical practice, increasing accessibility, and speeding up the health and economic benefits associated with biosimilars.
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Affiliation(s)
- Deeksha Joshi
- Chitkara College of Pharmacy, Chitkara University, Rajpura 140401, India
| | - Rubiya Khursheed
- School of Pharmaceutical Sciences, Lovely Professional University, Phagwara 144411, India
| | - Saurabh Gupta
- Chitkara College of Pharmacy, Chitkara University, Rajpura 140401, India
| | - Diksha Wadhwa
- Chitkara College of Pharmacy, Chitkara University, Rajpura 140401, India
| | | | - Sumit Sharma
- Delhi Pharmaceutical Sciences and Research University, New Delhi 110017, India
| | - Sejal Porwal
- Department of Pharmaceutical Sciences, Amity University Lucknow, Lucknow 226028, India
| | - Swati Gauniyal
- Department of Pharmacology, KLE College of Pharmacy, Hubballi 580031, India
| | - Sukriti Vishwas
- School of Pharmaceutical Sciences, Lovely Professional University, Phagwara 144411, India
| | - Sanjay Goyal
- Department of Internal Medicine, Government Medical College, Patiala 147001, India
| | - Gaurav Gupta
- School of Pharmacy, Suresh Gyan Vihar University, Mahal Road, Jagatpura 333031, India
- Department of Pharmacology, Saveetha Dental College, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai 602117, India
- Uttaranchal Institute of Pharmaceutical Sciences, Uttaranchal University, Dehradun 248007, India
| | - Rajaraman D. Eri
- School of Science, STEM College, RMIT University, Melbourne, VIC 3001, Australia
- Correspondence: (R.D.E.); (S.K.S.); Tel.: +61-3-6324-5467 (R.D.E.); +91-9888720835 (S.K.S.)
| | - Kylie A. Williams
- Discipline of Pharmacy, Graduate School of Health, University of Technology Sydney, Ultimo, NSW 2007, Australia
| | - Kamal Dua
- Discipline of Pharmacy, Graduate School of Health, University of Technology Sydney, Ultimo, NSW 2007, Australia
- Faculty of Health, Australian Research Centre in Complementary and Integrative Medicine, University of Technology Sydney, Ultimo, NSW 2007, Australia
| | - Sachin Kumar Singh
- School of Pharmaceutical Sciences, Lovely Professional University, Phagwara 144411, India
- Faculty of Health, Australian Research Centre in Complementary and Integrative Medicine, University of Technology Sydney, Ultimo, NSW 2007, Australia
- Correspondence: (R.D.E.); (S.K.S.); Tel.: +61-3-6324-5467 (R.D.E.); +91-9888720835 (S.K.S.)
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Waller CF, Friganović A. Biosimilars in oncology: key role of nurses in patient education. Future Oncol 2020; 16:1931-1939. [PMID: 32618476 DOI: 10.2217/fon-2020-0486] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
Biosimilars have the potential to lower costs and increase patient access to life-saving cancer therapies. However, lack of familiarity with biosimilars can be a barrier to their adoption, limiting their health and economic benefits. As highly trusted healthcare providers, nurses play integral roles in patient education. This review aims to help prepare nurses to respond to potential questions from patients on biosimilars. The regulation, use and potential benefits of biosimilars are discussed, with a focus on biosimilars in oncology. Overall, biosimilars are highly regulated medicines that provide comparable benefits to available biologics. Nurses can influence the adoption of biosimilars through patient education and can impact the future of the field in their expanding roles within health care systems.
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Affiliation(s)
- Cornelius F Waller
- Department of Haematology, Oncology & Stem Cell Transplantation, University Medical Centre Freiburg & Faculty of Medicine, University of Freiburg, 79106 Freiburg, Germany
| | - Adriano Friganović
- Department of Anesthesiology & Intensive Medicine, University Hospital Centre Zagreb, 10000 Zagreb, Croatia.,Department of Nursing, University of Applied Health Sciences, 10000 Zagreb, Croatia
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Foreman E. Biosimilars in supportive care. Curr Opin Oncol 2020; 32:282-288. [PMID: 32541314 DOI: 10.1097/cco.0000000000000631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE OF REVIEW This review covers recent publications relating to the use of biosimilar medicines in the supportive care of cancer patients, and broader publications focussed on the benefits and challenges of implementing biosimilars into clinical practice. RECENT FINDINGS A metaanalysis and a number of systematic literature reviews have confirmed that the safety and efficacy of biosimilar versions of epoetin-α, filgrastim and infliximab are equivalent to those of their corresponding reference biologics. New guidelines have been issued concerning the interchangeability of biosimilars and the practice of substituting a biosimilar in place of a prescribed reference product. The introduction of biosimilars into a health system has been shown to improve patient access to treatment while also delivering cost savings, however, there are a number of barriers that can prevent or delay the adoption of biosimilars into clinical practice which must be overcome for the potential benefits of biosimilars to be realized. SUMMARY There is a large amount of data to demonstrate that supportive care biosimilars are well tolerated and effective, with over 10 years of experience in Europe. We can learn from the challenges faced when introducing biosimilars into supportive care to facilitate the introduction of newer biosimilars into the treatment setting.
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Affiliation(s)
- Emma Foreman
- Pharmacy Department, The Royal Marsden NHS Foundation Trust, London, UK
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Gregory GP, Carrington C, Cheah CY, Hawkes EA, Irving IM, Siderov J, Opat S. A consensus statement on the use of biosimilar medicines in hematology in Australia. Asia Pac J Clin Oncol 2020; 16:211-221. [PMID: 32285612 DOI: 10.1111/ajco.13337] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Accepted: 03/08/2020] [Indexed: 12/31/2022]
Abstract
Despite their availability for over a decade, the exact nature of biosimilar medicines is still poorly understood with paucity of clear treatment guidelines for their use in clinical practice in Australia. Although hematologists have had experience with biosimilars in the setting of supportive care, with the approval of the first biosimilar rituximab in hematological malignancies, it is important to revisit this topic. To inform the use of biosimilar medicines in clinical practice, we have developed a consensus statement from an Expert Panel of Australian hematologists, oncologists, and cancer pharmacists. These recommendations address the approach to use of biosimilar products in place of the corresponding reference medicine in a number of different clinical contexts. Our recommendations are based on the premise that biosimilar medicines can be considered therapeutically equivalent to their reference brand and used in a similar way to the reference product in any approved indication. We advocate for local approaches to the provision of patient information, dispensing of the intended brand and pharmacovigilance, to be developed in consultation with local hematologists and aim to improve confidence in the appropriate use of biosimilar medicines and their expected outcomes among hematologists.
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Affiliation(s)
- Gareth P Gregory
- Monash Haematology, Monash Health, Clayton, Victoria, Australia.,School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
| | - Christine Carrington
- Department of Pharmacy, Princess Alexandra Hospital, Brisbane, Queensland, Australia.,School of Pharmacy, University of Queensland, Brisbane, Queensland, Australia
| | - Chan Y Cheah
- Sir Charles Gairdner Hospital and Pathwest Laboratory Medicine WA, Nedlands, Western Australia, Australia.,Medical School of Pathology and Laboratory Medicine, University of Western Australia, Crawley, Western Australia, Australia
| | - Eliza A Hawkes
- Olivia Newton-John Cancer Research & Wellness Centre, Austin Health, Melbourne, Victoria, Australia.,Eastern Health, Melbourne, Victoria, Australia
| | - Ian M Irving
- The Wesley Hospital, Auchenflower, Queensland, Australia.,Icon Group, Brisbane, Queensland, Australia
| | - Jim Siderov
- Department of Pharmacy, Austin Health, Melbourne, Victoria, Australia
| | - Stephen Opat
- Monash Haematology, Monash Health, Clayton, Victoria, Australia.,School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia.,Clinical Haematology, Alfred Health, Melbourne, Victoria, Australia
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Cuellar S, McBride A, Medina P. Pharmacist perspectives and considerations for implementation of therapeutic oncology biosimilars in practice. Am J Health Syst Pharm 2019; 76:1725-1738. [DOI: 10.1093/ajhp/zxz190] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Abstract
Purpose
An overview of therapeutic oncology biosimilars, the U.S. biosimilars regulatory pathway, and the clinical development of selected biosimilar products is provided, including discussion of considerations in adopting biosimilars into oncology practice.
Summary
Biosimilars are biologic agents that are highly similar to and have no clinically meaningful differences from an approved reference product in terms of safety, purity, and potency. There is a large market for cancer biologics, and approval of biosimilars has the potential to increase access to care and reduce costs. An abbreviated regulatory pathway for the development and approval of biosimilars defines a stepwise approach to demonstrating biosimilarity and conducting clinical comparative trials to confirm equivalent pharmacokinetics, efficacy, safety, and immunogenicity to the reference product. Three therapeutic biologics (bevacizumab, trastuzumab, and rituximab) have been used extensively in the treatment of a variety of cancers and are targets for biosimilar product development. Preclinical and clinical experience with 2 recently approved biosimilars to bevacizumab and trastuzumab is reviewed. Challenges faced by pharmacy and therapeutics committees when considering oncology biosimilars for formulary inclusion are discussed.
Conclusion
Increased adoption of biosimilars could potentially lower treatment costs and improve access to biologics for patients with cancer. Key considerations in formulary review of biosimilars include the quality and quantity of data from comparative clinical trials, economic factors, manufacturer reliability, and challenges associated with incorporating biosimilars into practice.
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Affiliation(s)
- Sandra Cuellar
- University of Illinois at Chicago, College of Pharmacy, Chicago, IL
| | - Ali McBride
- University of Arizona Cancer Center, Tucson, AZ
| | - Patrick Medina
- University of Oklahoma Stephenson Cancer Center, Oklahoma City, OK
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