Shutterstock.com
The National Institute for Health and Care Excellence (NICE) has recommended a combination treatment for early breast cancer that helps to prevent the disease returning.
In final draft guidance published on 17 July 2025, NICE recommended ribociclib (Kisqali; Novartis) for the adjuvant treatment of hormone receptor-positive, HER2-negative early breast cancer, which has responded to initial treatments, including surgery, but where the cancer has a higher risk of return.
Ribociclib should be used with an aromatase inhibitor, the NICE guidance has specified.
The treatment was previously recommended for patients whose cancer has spread to their lymph nodes.
NICE has estimated that its new guidance will make the treatment available to a further 5,700 patients.
The British Oncology Pharmacy Association (BOPA) and patient charity Breast Cancer Now have welcomed the guidance, although both noted the potential impact on the cancer workforce.
Michal Sladkowski, a breast cancer specialist pharmacist and secretary of BOPA, who was involved in the development of the guidance, said the approval “represents a significant shift in the treatment pathway for early breast cancer”.
He noted that the expansion of the treatment to more patients “will have an impact on outpatient clinic capacities” and that pharmacists would “play a crucial role in supporting this cohort of patients, from toxicity management, patient education and general support”.
“Given the complexity and increased cohort of patients on ribociclib, this reinforces the need for specialist pharmacist input within multidisciplinary teams,” he added.
“BOPA welcomes this advancement and looks forward to supporting our oncology pharmacist members as they embed this into clinical practice.”
Claire Rowney, chief executive of Breast Cancer Now, told The Pharmaceutical Journal: “Crucially, this decision means thousands more people in England with early breast cancer will benefit from a promising treatment that could cut the risk of cancer coming back by almost a third, and in turn, will help alleviate some of the anxiety so many people feel about their cancer returning.”
However, she added that the government needed to take “urgent action” to address cancer workforce shortages, as well as “deliver interim support for struggling local cancer services to ensure they have capacity to deliver this and other treatments to patients who so desperately need them”.
She also said the “almost three-month delay in reaching a full approval for this treatment” was “deeply disappointing”.
“It’s vital that people with breast cancer can count on accessing new, effective treatments without delay, at the time they need them. The Scottish Medicines Consortium must now consider this treatment at pace, so that we see it made available to all who need it across the UK,” she added.
