NICE says patient benefits of breast cancer drug are too small to justify its very high cost
The National Institute for Health and Clinical Excellence (NICE) has been asked to assess whether bevacizumab (Avastin, Roche Products), when used in combination with a taxane (a type of chemotherapy), would be a useful and cost-effective treatment option for people with breast cancer which has spread to other parts of the body. In final draft guidance published today (8 December) NICE does not recommend the drug on the grounds that it offers limited and uncertain benefit for patients compared with existing treatments.
Sir Andrew Dillon, NICE Chief Executive, said: "We know that it's immensely important for breast cancer patients, whose disease has spread, to prolong their lives as much as possible.
"Unfortunately, we did not receive any evidence from the manufacturer to show that bevacizumab can significantly lengthen a patient's life or, importantly, offer a better quality of life than existing treatments. Although the data seemed to show that the drug may slow the growth and spread of the cancer, the size of this effect varied between studies. Furthermore, it was extremely unclear that the benefits in terms of slowing tumour growth translated into benefits on overall survival, which is what really matters for patients."
Sir Andrew Dillon added: "We also are aware that the United States Food and Drug Administration and the European Medicines Agency are currently reconsidering bevacizumab's licence as a treatment for metastatic breast cancer. We have nevertheless decided to continue our appraisal. If either the FDA or the EMA announce changes to their licensing decision, which affects our advice to the NHS, we amend it accordingly."
This draft guidance is now subject to an appeal process whereby consultees can appeal against the recommendation. Final guidance is expected to be published early next year but until then, NHS bodies should make decisions locally on the funding of specific treatments.