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NICE turns down Roche's Perjeta for post-surgery HER2-positive breast cancer

Published on 15/06/18 at 10:04am

Roche’s ongoing dispute with UK health service watchdog NICE over the availability of its monoclonal antibody Perjeta (pertuzumab) on the NHS for the treatment of HER2-positive breast cancer after surgery in patients with high risk of disease recurrence.

The drugmaker has struggled to convince NICE of the drug’s cost-effectiveness in the past, and this same point proved to be a sticking point for the organisation once again in this latest indication. The watchdog also raised concerns about the therapy’s efficacy in improving overall survival due to lack of evidence, and noted that adding Perjeta to trastuzumab made only a “small difference” to the proportion of patients who remained free of invasive disease.

“There was a great deal of uncertainty in the available evidence of clinical effectiveness compared to existing treatments which led the committee to conclude that pertuzumab as adjuvant treatment may not result in meaningful additional benefits for patients,” noted Meindert Boysen, Director of the Centre for Technology Evaluation at NICE.“We’re therefore not currently able to recommend pertuzumab as a clinically and cost effective option for people who have a higher risk of their cancer returning.”

NICE has already given the go-ahead for the use of Perjeta in combination with trastuzumab and chemotherapy for the treatment of early HER2-positive breast cancer prior to surgery and for treating HER2-positive breast cancer that has recurred after initial treatment or has metastasised to other parts of the body.

Roche’s General Manager Richard Erwin said of the decision: “Although we are disappointed in the draft guidance published, we won’t walk away from this group of women living with HER2-positive, early breast cancer who have a high-risk of their breast cancer returning and who could benefit from adding Perjeta to their treatment-regimen.

“This medicine has been shown to offer value to high-risk patients and physicians should have the option to use the medicine if they feel it will help to prevent breast cancer from returning,” he continued. “The fact that it has already been approved by regulatory organisations in the US and EU and recognised by international treatment guidelines is testament to its potential.”

Matt Fellows

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