The National Institute for Health and Care Excellence (NICE) looks likely to go back on previous draft guidance that would have limited the use of Roche’s cancer drug Tarceva.
In February this year NICE, which assess the cost-effectiveness of treatments for NHS use in England and Wales, said it was reviewing its recommendations for both Roche’s Tarceva (erlotinib) and AstraZeneca’s Iressa (gefitinib) in the treatment of non-small cell lung cancer (NSCLC).
The new guidance would have overturned NICE’s previous recommendation, which allows Tarceva – an inhibitor of the EGFR protein associated with cancer – to be used on the NHS as a second-line treatment for patients with NSCLC.
This was down to the agency’s position that retreatment of NSCLC after failure of first-line therapy with an EGFR inhibitor is not common in clinical practice because of reduced sensitivity of the tumour to these treatments, as well as data that suggested that Tarceva was not as effective as docetaxel in extending progression-free survival (PFS) when used in NSCLC patients without any mutation in the EGFR gene.
NICE now appears to have backtracked on this potential new recommendation and has published guidance that does back the continued use of Tarceva for people with relapsed NSCLC.
This decision was made following consultation with patients, doctors and Roche, causing the pharma company to proclaim in its response: “The voices of clinicians and patients have been heard.”
According to the company, losing Tarceva’s recommendation as a second-line treatment would have affected up to 2,000 patients a year who fail first-line therapy and cannot tolerate docetaxel.
Dr Mick Peake, consultant physician at the University Hospitals of Leicester NHS Trust and clinical lead for the National Cancer Intelligence Network (NCIN), said he was “glad” that NICE took patient opinion into consideration and reverse its negative stance.
“I am therefore extremely relieved that erlotinib will continue to be available through the NHS as a treatment option for patients with relapsed NSCLC,” said Dr Peake.
This latest guidance is now up for consultation with comments welcomed until April 29. A final decision on the use of Tarceva and Iressa is expected by September.