NICE set to recommend new ‘gold standard’ treatments for early-stage breast cancer
pharmafile | May 30, 2006 | News story | |
Three early breast cancer drugs are a step closer to overtaking the current gold standard treatment, after preliminary recommendation from NICE.
The Institute found AstraZeneca's Arimidex, Novartis' Femara and Pfizer's Aromasin to be cost and clinically effective treatments for early oestrogen-receptor-positive breast cancer after surgery.
The three aromatase inhibitors are now set to replace the 30-year-old drug tamoxifen as the current standard treatment for the disease.
Prof Mike Baum, emeritus professor of surgery at University College London commented: "This landmark NICE decision truly marks a major advance in the treatment of hormone-positive early breast cancer in postmenopausal women in the UK.
"By embracing these innovative treatment options for use immediately after surgery, when the risk of recurrence is greatest in all patients, NICE has confirmed that aromatase inhibitors are becoming the gold standard treatment and has allowed all eligible women access to more effective and better tolerated treatments".
Tamoxifen is usually taken for five years, but long-term use of the drug can be associated with a number of side effects including an increased risk of cancer of the uterus and thromboembolic events.
Under NICE's preliminary recommendations, the first post-surgery (adjuvant) treatment for early oestrogen-receptor-positive breast cancer patients would be an aromatase inhibitor.
The recommendations assume the aromatase inhibitors are used within their licensed indications.
For postmenopausal women with hormone-positive early breast cancer, Femara currently has the widest range of indications of these three drugs, with approval as an adjuvant treatment and after prior use of tamoxifen as adjuvant therapy.
Arimidex is approved as an adjuvant treatment and Aromasin is indicated for adjuvant treatment in patients who have first had 2-3 years of tamoxifen.
The choice of whether to start patients on an aromatase inhibitor, switch to one from tamoxifen or wait until the five-year course of tamoxifen has been completed should be made after risk-benefit discussions between patient and clinician.
NICE is due to issue its final guidance on the treatments later this year in November, but patient groups are keen to highlight that clinicians can prescribe them before this.
Cancerbackup's chief executive Joanne Rule said: "Until full approval is given by NICE, it is important to remember that if a woman and her clinician decide that a certain treatment is suitable, there is nothing to prevent Primary Care Trusts from prescribing it as they do not need to wait for NICE guidance."
Some 23,000 women are diagnosed with early breast cancer each year in the UK and AstraZeneca's Arimidex is the currently the most popular aromatase inhibitor among prescribers.
However, NICE in its deliberations found no evidence to suggest one product was more clinically effective than another.
