Reply to Trudeau, M.; Fraser, B. The CADTH pCODR Expert Review Committee Process Explained. Comment on "Rayson et al. Access to Neoadjuvant Pertuzumab for HER2 Positive Breast Cancer in Canada: A Dilemma Increasingly Difficult to Explain. Curr. Oncol. 2022, 29 , 9891–9895"

Due to the high cost of most novel cancer therapies, this in turn hinders public funding for therapies with a "Do Not Reimburse" recommendation from CADTH. Although not specifically submitted by the industry sponsor, the incremental improvement in pCR rate afforded by the addition of neoadjuvant pertuzumab would allow treatment de-escalation for approximately one out of six patients. This observation led to the design of the KATHERINE trial, which tested trastuzumab emtansine as adjuvant therapy specifically for those patients not achieving pCR after neoadjuvant HER2-based therapy and demonstrated significant improvements in disease-free survival (DFS) for this high-risk patient population [[7]]. [Extracted from the article]