The National Institute for Health and Clinical Excellence (NICE) has today (23 February) published final guidance to the NHS not recommending the use of bevacizumab (Avastin, Roche Products), when used in combination with a taxane (a type of chemotherapy drug), as a first-line treatment for people with metastatic breast cancer.
Sir Andrew Dillon, NICE Chief Executive, said: “The evidence for the effectiveness of bevacizumab in prolonging survival was not robust and overall did not show enough of a demonstrable benefit for it to be considered a cost-effective use of NHS resources.”
An independent Appraisal Committee, who developed this guidance on behalf of NICE, considered evidence from the manufacturer, clinical experts and patient and PCT representatives. Clinical trial data suggested that, for breast cancer patients whose tumours have spread elsewhere in the body, bevacizumab (when used with the taxane drug, paclitaxel) may slow the growth and spread of the cancer by around five months more than paclitaxel alone. However, due to uncertainties in the evidence, the committee was unable to conclude whether bevacizumab could extend a patient’s life, or how long for. There was also no evidence to show if the drug could offer a better quality of life than existing treatments.
Sir Andrew Dillon added: “NICE is committed to ensuring the most effective and efficient treatments, both for patients and the NHS, are available to those who need them. With this in mind, we already recommend a range of treatment options for patients with metastatic breast cancer in our clinical guideline for advanced breast cancer.”
The publication of this NICE guidance for bevacizumab comes after the Committee for Medicinal Products for Human Use (CHMP), part of the European Medicines Agency (EMA), recently recommended restricting the treatment’s UK marketing authorization so that doctors only prescribe bevacizumab in combination with the taxane drug, paclitaxel. Meanwhile, the United States Food and Drug Administration (FDA) voted in December 2010 to completely rescind bevacizumab’s licence in America because of concerns over efficacy.
Source: NICE