NICE recommends Boehringer’s lung cancer drug Giotrif

NICE has recommended Giotrif (afatinib), Boehringer Ingelheim's treatment for non-small-cell lung cancer (NSCLC).

The drug joins the competition in the targeted-therapy market in lung cancer, where Roche's Tarceva (erlotinib) and AstraZeneca's Iressa (gefitinib) are already well established.

NICE says Giotrif can be used on the NHS to treat locally advanced or metastatic NSCLC in people whose tumours test positive for the EGFR-TK mutation and have not received an existing EGFR-TK inhibitor, such as Tarceva and Iressa.

Afatinib is a targeted therapy known as an EGFR-TK inhibitor. It works by blocking the signal pathways helping to slow the growth and spread of tumours. Non-small-cell lung cancer is now tested for EGFR-TK mutation status at diagnosis before people receive their 'first-line' therapy to ensure that the most appropriate treatment is selected.

Sir Andrew Dillon, Chief Executive of NICE, said: "We've already recommended two drugs, gefitinib and erlotinib, as options for the first-line treatment for patients with this form of lung cancer and we're pleased that this draft guidance recommends a further option."

NICE's expert committee has decided that an appraisal consultation document was not needed for this appraisal, and the recommendation therefore goes straight to a final draft in order to speed up access to the treatment.

The draft guidance is now with consultees. Until NICE issues final guidance, NHS bodies should make decisions locally on the funding of specific treatments.

Head-to-head with Tarceva

Boehringer has a head-to-head trial pitching Giotrif against market leader Tarceva already under way. Lux-Lung 8 is an open-label phase III trial comparing the drugs as second-line therapy following platinum-based chemotherapy.

The study is due to be completed in November 2015, and if it shows Giotrif to be superior to Tarceva in extending progression free survival or overall survival, the results would put Boehringer's drug in a strong position.

However oncologists currently believe that combinations of newer targeted drugs, rather than single agents, will be the way forward for extending overall survival for lung cancer patients.

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