NICE turns down two breast cancer drugs

Benefits of drugs 'unclear'

The National Institute for Health and Clinical Excellence (NICE) has today turned down two drugs for the treatment of breast cancer.

In its final draft guidance, NICE does not recommend lapatinib (Tyverb) or trastuzumab (Herceptin) with a type of hormone therapy called aromatase inhibitors for a particular type and stage of breast cancer.

It says this is because it is unclear how much either drug can improve overall survival compared to existing treatments, and because they do not appear to represent value for money for the NHS.

NICE is currently developing guidance for the NHS on the use of lapatinib or trastuzumab specifically as first line treatment options to delay the growth of advanced breast cancer that has spread to other parts of the body, and which reacts with the hormones oestrogen or progesterone, as well as having high levels of a protein called HER2 on the surface of its cells.

Once published, the guidance will only advise on the use of these drugs alongside aromatase inhibitors.

This final draft document published today follows a public consultation in February on NICE’s provisional recommendations.

Sir Andrew Dillon, chief executive of NICE, said: “Having reviewed the available evidence, our committee of experts has found that while both lapatinib and trastuzumab can reduce the growth and further spread of metastatic breast cancer tumours when taken alongside the aromatase inhibitors letrozole and anastrozole, the extent to which these treatments can improve overall survival appears to be small or difficult to quantify.

“Furthermore, independent economic analyses indicate that neither treatment combination appears to be cost effective for the NHS. Confidence about the additional benefits that new treatments provide is important both for patients and for those who have responsibility for managing the resources available to the NHS.”

He added that the draft guidance has been published on the NICE website for interested parties to respond before it publishes final guidance for the NHS, which is expected to come out in June 2012.

NICE says that if women are already receiving either option when the final guidance is published, they should be able to continue treatment until they and their doctors consider it appropriate to stop.

Earlier this month, NICE published draft guidance in which it turned town the breast cancer drug bevacizumab (Avastin) for use in combination with the chemotherapy drug capecitabine.

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