NICE draft guidance does not recommend pembrolizumab plus chemo for triple negative breast cancer
pharmafile | March 9, 2022 | News story | Research and Development |
Draft guidance published by NICE for public consultation does not recommend pembrolizumab in combination with chemotherapy (paclitaxel or nab-paclitaxel) for treating triple negative breast cancer that has spread to other parts of the body.
Around 600 people in England with advanced triple negative breast cancer would have been eligible for treatment with the pembrolizumab combination.
“I know that today’s announcement will be disappointing for people with this type of breast cancer, as well as for their families and carers,” said Helen Knight, programme director in the NICE Centre for Health Technology Evaluation. “Advanced triple negative breast cancer has a significant negative impact on quality of life. It can be more aggressive than other types of breast cancer and accounts for a quarter of all deaths from breast cancer despite accounting for only 1 in 5 cases.”
Evidence showed that pembrolizumab plus chemotherapy is more effective than paclitaxel or nab-paclitaxel, although the long-term benefit is uncertain. In addition, there was no trial data directly comparing pembrolizumab plus chemotherapy with atezolizumab plus chemotherapy, another targeted treatment which NICE already recommends.
The committee noted that the results of an indirect comparison would need to be interpreted with caution because of differences between the trials. Additionally, the cost-effectiveness estimates are higher than NICE usually considers an acceptable use of NHS resources.
“NICE already recommends atezolizumab with chemotherapy, the only other targeted treatment for this type of breast cancer, and another treatment is in our pipeline to be looked at,” continued Helen Knight. “However, there are people who aren’t eligible for atezolizumab combination who could be eligible for pembrolizumab with chemotherapy.”
NICE has shared that it would like to see more information on the comparison between pembrolizumab plus chemotherapy with atezolizumab plus chemotherapy.
“We are committed to working with the company to try to resolve the issues identified by the committee,” added Helen Knight. “In the meantime, I would encourage anyone with an interest in this topic to give us their feedback on this draft guidance.”
Ana Ovey
