NICE turned down advanced breast cancer drug

Hannah Blake

pharmaphorum

The National Institute for Health and Clinical Excellence (NICE) has decided that the drug, Avastin, will not be offered to women with metatastic breast cancer on the NHS when used in combination with capecitabine. Avastin, also known as bevacizumab, works by starving the tumour of blood, and has already been turned down by NICE for use in bowel cancer, kidney cancer and lung cancer.

NICE considered the drug for the 11,000 women in England and Wales whose breast cancer has spread to other parts of the body, as well as a subgroup of 800 women who have already been treated with a drug called taxanes, for whom Avastin seems to work best with, but decided there was no evidence to suggest the drug is a cost-effective use of NHS resources. However, NICE is appraising bevacizumab in combination with capecitabine for first-line treatment of metatastic breast cancer where other treatment options are inappropriate.

The latest draft of NICE guidance has been developed by an independent Appraisal Committee following a thorough review of the available evidence and a public consultation earlier this year.

“Breast cancer is one of the most common cancers and we understand how vital it is that patients receive effective treatments, especially once the cancer spreads to other parts of the body. However, although the evidence on which this draft guidance is based did suggest that bevacizumab plus capecitabine could delay cancer from progressing for longer than capecitabine alone, there was no evidence to show bevacizumab led to an improvement in overall survival. Taking these uncertainties into account as well as the high cost of the drug, the committee concluded that bevacizumab was not a cost-effective use of NHS resources.”

Sir Andrew Dillion, Chief Executive of NICE.

However, Avastin’s drug manufacturer, Roche, collected data showing that the drug can stall breast cancer for four months, and extend life by eight months to more than two years. A spokesman for the company said Avastin is one of the most commonly prescribed drugs through the government’s Cancer Drugs Fund. The Cancer Drugs Fund is designed to give patients access to medication turned down by NICE.