Final draft guidance from the National Institute of Health and Care Excellence (NICE) recommends Kadcyla (trastuzumab emtansine) for routine use in advanced breast cancer after manufacturer Roche agreed to reduce the cost of the drug to the NHS.
The drug had previously been available only through the Cancer Drugs Fund since 2014, and in 2016 was rejected for routine funding by NICE, England’s health technology assessment body, on grounds of cost. The full list price is £90,000 per year.
The decision to approve the drug, which will be made final next month, came after more than 115,000 people signed a petition launched by the charity Breast Cancer Now asking NICE and Roche to work together to overturn the initial rejection.
The treatment is recommended for patients with advanced human epidemal growth factor receptor 2 (HER2)-positive breast cancer that cannot be treated surgically, and who have already received herceptin (trastuzumab) and a taxane, separately or in combination.
Kadcyla contains a monoclonal antibody that targets the HER2 receptor, like herceptin, but it is conjugated to a cytotoxic agent called emtansine to deliver the chemotherapy into cancer cells. In clinical trials, it improved overall survival by nearly six months in women with advanced disease compared with lapatinib and capecitabine, the previous standard of care.
About 1,200 women will be eligible for the drug once it becomes routinely available.
Kadcyla was assessed as part of a review being carried out by NICE of all drugs in the Cancer Drugs Fund. So far, all 17 that have been assessed have been moved to routine use following price deals with manufacturers.
“Since we started reassessing the drugs available through the Cancer Drugs Fund, companies have responded positively and shown that they can offer good deals when it comes to pricing,” says Carole Longson, director of the NICE centre for health technology evaluation. “This has meant that we have been able to recommend these drugs for routine funding, which is clearly very good news for both patients and the NHS.”