Draft guidance recommends treatments for breast and lung cancer in UK

Draft guidance has been published today recommending two cancer drugs for routine use on the UK’s National Health Service as part of its program to appraise treatments that were first made available on the Cancer Drugs Fund before it was reformed earlier this year.

The National Institute for Health and Care Excellence (NICE) is looking again at Swiss pharma giant Novartis’ Afinitor (everolimus), in combination with the drug exemestane, for treating HER2-negative, hormone-receptor-positive advanced breast cancer and crizotinib for treating non-small-cell lung cancer.

Novartis offered a larger discount to the NHS meaning the NICE can now provisionally recommend it for routine funding on the NHS.

Everolimus is licensed for use in postmenopausal women with this type of breast cancer if their disease has returned or progressed following initial treatment with a non-steroidal aromatase inhibitor (a type of hormone therapy) and if they have no symptoms from visceral disease (when the cancer has spread to the body’s other organs).

Everolimus is taken in tablet form and costs between £2,250 ($2,824) and £2,673 per patient for a month’s treatment without the confidential discount.

Professor Carole Longson MBE, director of the centre for health technology assessment at NICE, said: “The committee heard that people with breast cancer would value treatments like everolimus that can be given when limited options exist once their disease becomes resistant to endocrine therapy, and because it may delay the need for chemotherapy and its associated side-effects,” said Carole Longson, director of the NICE Centre for Health Technology Assessment.

Prof Longson added: “The committee concluded that everolimus with exemestane is effective in delaying the growth and spread of breast cancer and, with the revised patient access scheme, is a cost effective use of NHS resources. We are therefore pleased to recommend everolimus for routine funding for the estimated 1,500 people who are eligible to receive it.”

Also recommends Pfizer’s Xalkori

In further draft guidance published today the NICE has recommended US pharma giant Pfizer’s (NYSE: PFE) Xalkori (crizotinib) as a second-line treatment option for some people with lung cancer.

In the NICE’s original guidance, crizotinib was not considered cost-effective as the evidence base was immature and there was uncertainty over its overall survival gain. For the reappraisal Pfizer provided analyses with newer clinical evidence as well as a further discount on the price. The NICE already recommends crizotinib as a first- line option for some lung cancer patients.

The final draft guidance for everolimus and crizotinib is now with consultees, who have the opportunity to appeal against the draft recommendations. Until the NICE issues final guidance, NHS bodies should make decisions locally on the funding of specific treatments. Once NICE recommends a treatment 'as an option', the NHS must make sure it is available within three months (unless otherwise specified) of its date of publication.