Mike: Hello, I'm Mike Clarke, podcast editor for the Cochrane Library. Alongside Cochrane Reviews of the effects of original drugs for the treatment of some diseases, reviews are starting to appear of the effects of biosimilars for these drugs. In this podcast, Roses Parker, Cochrane’s Commissioning Editor tells us about the evidence in one of these reviews, published in November 2024, which considers biosimilar monoclonal antibodies for the treatment of patients with cancer.

Roses: In the current decade, biosimilars for monoclonal antibodies have become available for the treatment of a variety of types of cancer, including lung, colorectal and breast cancer, and non-Hodgkin’s lymphoma.
In simple terms, biosimilars are medicines similar to what are called the “originators”, which are known as reference or innovator medicines in some countries. The originator is the first medicine to receive approval from a regulatory agency. The biosimilars have minor structural differences to the originator and are developed with the aim of introducing products to the market that are similar in terms of quality, safety, and efficacy, but cost less.
Since biosimilars are not chemically identical to the originator medicines, healthcare professionals and people in treatment are often concerned about their use. Therefore, it’s important to know whether drugs such as biosimilar monoclonal antibodies are as safe and effective as the originator and many studies have been done to look at this. This review looks at those studies to assess the biosimilars for three widely used drugs, bevacizumab, rituximab, and trastuzumab, and shows that the biosimilars have similar effects to the originators.
In total, the review includes 55 relevant studies, with approximately 22,000 participants who had one of four main types of cancer: lung, colorectal, non-Hodgkin lymphoma, or breast cancer.
A group of patients helped the reviewers to identify the most important outcomes to study and, considering progression-free survival, duration of response, overall survival, serious adverse events, and objective response, treatment with bevacizumab biosimilars seems to be similar to bevacizumab itself in patients with lung or colorectal cancer. Patients with non-Hodgkin lymphoma who received a rituximab biosimilar also achieved similar results to those treated with the originator; as did those with breast cancer who were given a trastuzumab biosimilar or the originator.
Overall, the reviewers are moderately confident in the evidence for most of the outcomes they assessed. This current evidence base means that when considering a bevacizumab biosimilar for the treatment of lung or colorectal cancer, a rituximab biosimilar for the treatment of non-Hodgkin lymphoma, or a trastuzumab biosimilar for the treatment of breast cancer, the results will likely be similar to those achieved with the originator medicine. The review also lists 10 ongoing studies, and the reviewers anticipate updating their work to incorporate these when the results are available.

Mike: If you would like to read the current version of the review and watch for the update which will add in those studies, it’s available online. If you visit Cochranelibrary.com and type “biosimilar monoclonal antibodies” in the search box, you will see the link to it.