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Hoffmann-La Roche Limited (Roche Canada) announced that it has successfully completed negotiations with the pan-Canadian Pharmaceutical Alliance (pCPA) for Perjeta (pertuzumab for injection) in combination with trastuzumab and chemotherapy as a neoadjuvant treatment for patients with human epidermal growth factor receptor 2 (HER2)-positive, locally advanced, inflammatory or early-stage breast cancer (either >2 cm in diameter or node positive). The pCPA negotiates price on behalf of the provinces and territories, making the end of these negotiations on August 10, 2026, a critical step in bringing Perjeta in the neoadjuvant setting closer to public access.
This milestone could help Canadian patients with HER2-positive, early breast cancer access a proven treatment regimen in a neoadjuvant setting. HER2-positive breast cancer represents 10–20 per cent of breast cancer cases in Canada and is associated with aggressive disease and high recurrence risk. Treating people with breast cancer early, before the cancer has spread, may improve the chance of preventing the disease from returning.
Neoadjuvant treatment is given before surgery and is aimed at reducing tumour size so it is easier to surgically remove. Pathologic complete response (pCR) refers to the absence of invasive cancer in the breast and/or lymph nodes and achieving pCR following neoadjuvant chemotherapy is a desirable outcome, frequently, as it enables optimization of subsequent treatment decisions.
Recognizing the critical importance of this treatment approach, the breast cancer community has long advocated for Canadian patient access. In response, public drug programs brought forward a Non-Sponsored Reimbursement Review. Canada's Drug Agency issued a positive recommendation on October 6, 2025, enabling Roche Canada and the pCPA to commence negotiations in February 2026 - a major breakthrough in advancing access to this indication. This collaborative momentum is highly valued, particularly as Perjeta in the neoadjuvant setting represents the established global standard of care for high-risk HER2-positive early-stage breast cancer.
Reaching this important milestone through close collaboration with pCPA has set the stage for the next critical phase. Roche Canada is committed to working with provincial and territorial jurisdictions to move quickly through their reimbursement decisions and make Perjeta in the neoadjuvant setting available as soon as possible through public drug plans for patients who need it.
"We are grateful for the constructive collaboration with our health system partners to finalize this agreement. Alongside this milestone, we applaud clinician and patient advocacy groups, whose tireless commitment keeps patient care at the centre of everything we do. We are now eager to work hand-in-hand with provincial and territorial jurisdictions to ensure every Canadian gains equitable access to this standard of care", said Simon Yunger, vice president, value pricing and reimbursement, Roche Canada.
"Perjeta in the neoadjuvant setting is valued by health care providers and patients as a neoadjuvant treatment of HER2-positive breast cancer. We are thrilled with the completion of negotiations for this essential treatment so that patients can have improved access to it. A breast cancer diagnosis can significantly alter a person's finances, and this is a bigger burden for those already in a precarious situation before their diagnosis. Public funding of staple treatments for individuals diagnosed with breast cancer provides benefits beyond their health", commends Cathy Ammendolea, Board Chair of Canadian Breast Cancer Network.
"This is a milestone, after years of advocacy, this much-needed agreement means equitable access for Canadian patients with HER2-positive breast cancer is within reach. This treatment is standard in most countries and may provide high-risk patients with a better outcome from their diagnosis. Today, Canada is closer to closing a critical treatment gap. We will continue to push for timely access to the treatments and innovations that Canadians deserve”, says Kimberly Carson, CEO of Breast Cancer Canada.
"For people diagnosed with HER2-positive early breast cancer, today's announcement is an important step forward. Perjeta in the neoadjuvant setting has been available to patients in many countries around the world for years, and now Canadians are one step closer to a treatment with demonstrated efficacy in early breast cancer. We are encouraged to see this resolution reached and hope it reflects a growing commitment to ensuring Canadian patients can benefit from innovation sooner. As new therapies continue to transform what is possible in cancer care, timely access must remain a priority so that people can receive the treatments they need, when they need them most", said MJ DeCoteau, Founder and Executive Director, Rethink Breast Cancer.
Perjeta is a targeted monoclonal antibody designed to bind to the HER2 protein on cancer cells, slowing or stopping their growth. It is specifically engineered to prevent the HER2 receptor from pairing (dimerizing) with other HER receptors, which is a process critical to tumour growth and survival.
Perjeta and trastuzumab complement each other by binding to different sites on the HER2 receptor. When used together with chemotherapy in the neoadjuvant setting, they deliver a comprehensive dual blockade of HER signalling pathways to inhibit tumour progression.
Breast cancer is the most common cancer among Canadian women and the second leading cause of cancer death, with an estimated 32,400 diagnoses and 5,400 deaths expected in 2026. Risk increases substantially with age, predominantly affecting women aged 50 to 69. Most cases in Canada are diagnosed at an early stage when curative-intent treatment can be used to help prevent recurrence.
HER2-positive disease occurs when cancer cells overproduce the HER2 protein (a substance that normally regulates cell growth) causing cells to divide and grow at an accelerated rate.
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