NICE 'minded not to approve two breast cancer drugs'

February 16, 2012

NICE draft guidance proposes to advise the NHS that lapatinib and trastuzumab, given alongside aromatase inhibitors, should not be given as a first treatment option to women with a particular type of advanced breast cancer.

The National Institute for Health and Clinical Excellence (NICE) has revealed in draft guidance that it does not believe two drugs, called lapatinib and trastuzumab, should be prescribed for a particular type and stage of breast cancer on the NHS.

The institute is currently preparing guidance on whether or not the NHS should offer lapatinib or trastuzumab as first-line treatment options to delay the growth of advanced breast cancer that has already spread.

Its guidance will only apply to women whose tumour cells react with oestrogen or progesterone, and have high levels of the protein HER2 on their surface.

In addition, the guidance will only advise on whether or not these two drugs should be prescribed alongside a type of hormone therapy called aromatase inhibitors.

Unless the institute is persuaded to change its mind in its final guidance, the decision will mean that most patients will need private medical insurance or will have to pay for the drugs if they wish to take them alongside aromatase inhibitors as their first-line option.

Sir Andrew Dillon, NICE's chief executive, explained that the extent to which these treatments can improve overall survival "appears to be small or undefined".

"Furthermore, independent economic analyses indicate that both treatment combinations do not appear to be cost-effective for the NHS because they have uncertain clinical benefits for the price that the NHS is being asked to pay," he added.

Carolyn Rogers, clinical nurse specialist at Breast Cancer Care, said that women who are already receiving either treatment combination should be able to continue treatment until their doctor thinks they should stop.

She added: "Whilst evidence suggests that the clinical benefit of this drug combination may be very small, even a minor clinical benefit can be extremely important for the patient."

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