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NICE approves Roche’s Tecentriq in TNBC after revising deal

Discounted price deal sees immunotherapy recommended for use


The UK’s National Institute for Health and Care Excellence (NICE) has recommended Roche’s immunotherapy Tecentriq for patients with triple-negative breast cancer (TNBC) after the Swiss pharma company offered a large discount for NHS England.

Draft guidance from NICE, released late last year, did not recommend the use of Tecentriq (atezolizumab) after determining that the drug was not cost-effective in the TNBC setting, even as a life-extending treatment at the end of life.

At that time, NICE added that Roche’s PD-L1 inhibitor “does not have the potential to be cost effective at the current price, and there is no clear evidence that further trial data would resolve the uncertainties”.

According to NICE, the full cost for a course of treatment with Tecentriq is £39,981, based on treatment for 7.5 months at its full list price, although Roche has offered the NHS a confidential discount.

TNBC is a particularly aggressive form of breast cancer, with few treatment options aside from surgery, radiotherapy and chemotherapy. TNBC tumours also lack oestrogen, progesterone and HER2 receptors so it isn’t possible to use drugs that target these biomarkers.

The recommendation is based on results from the phase 3 IMpassion130 study, where Tecentriq plus Celgene’s Abraxane (nab-paclitaxel) demonstrated a progression-free survival rate of 2.5 months, and an overall survival rate of around 9.5 months.

NICE has now recommended Tecentriq for use alongside Abraxane in metastatic TNBC patients who have not had chemotherapy to treat their disease and for whom surgery is not possible.

According to the cost-effectiveness agency, out of the approximately 2,000 people in England with TNBC, around 600 would be eligible for treatment with the Tecentriq/Abraxane combination therapy.

“We are pleased to have been able to work with the company to resolve the issues identified by the committee in our previous draft guidance. I know that today’s announcement will be welcomed by people with this type of breast cancer as well as for their families and carers,” said Meindert Boysen, director of the Centre for Health Technology Evaluation at NICE.

“Tecentriq is considered to be a breakthrough treatment in an area where there are currently few options. The committee heard that the availability of a new treatment that increases progression-free survival compared with chemotherapy alone will give hope to patients because it is important to them to be able to maintain a good quality life for as long as possible,” he added.

Currently, Roche is out in front with Tecentriq in the TNBC market, and is the first immunotherapy that specifically targets TNBC tumours that have PD-L1 expression of 1% or higher.

Merck & Co/MSD’s rival checkpoint inhibitor Keytruda (pembrolizumab) has not shown the same level of efficacy in TNBC, although it has shown promise when used prior to surgery in women with  this type of breast cancer.

Article by

26th May 2020

From: Research, Regulatory, Healthcare



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