NICE draft guidance continues negative on Roche's Avastin for metastatic breast cancer

Final draft guidance published today (July 6) by the UK’s drugs watchdog the National Institute for Health and Clinical Excellence (NICE) does not recommend Swiss drug major Roche’s (RGO: SIX) Avastin (bevacizumab), when used in combination with capecitabine (Xeloda, also from Roche), as a treatment for a particular set of people with metastatic breast cancer. This confirms an earlier negative draft guidance (The Pharma Letter April 18).

The NICE is appraising bevacizumab (in combination with capecitabine) for the first-line treatment of metastatic breast cancer in people for whom treatment with other chemotherapy options including taxanes or anthracyclines is not considered appropriate.

Sir Andrew Dillon, the NICE’s chief executive, said: “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 However, although the evidence on which this draft guidance is based did suggest that bevacizumab plus capecitabine could delay cancer from progressing for longer than capecitabine alone, there was no evidence to show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. There was also no information available on whether or not bevacizumab could improve a patient’s quality of life – an important point raised by the patient expert during the appraisal. 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 [National Health Service] resources.”