NICE recommends Herceptin for gastric cancer, blocks high dose Glivec
pharmafile | November 24, 2010 | News story | Sales and Marketing | Cancer, GIST, Glivec, HER2, Herceptin, NICE, gastric cancer
NICE has recommended Roche’s cancer drug Herceptin for patients with HER2 metastatic gastric cancer.
NICE was initially minded not to recommend the drug, which is already licensed to treat HER2+ metastatic breast cancer, but Roche’s new efficacy data swayed the cost-effectiveness body.
Herceptin (trastuzumab) is now recommended for use on the NHS in combination with cisplatin and either capecitabine or 5-fluorouracil as an option for certain patients with metastatic adenocarcinoma of the stomach and gastro-oesophageal junction who have high levels of HER2.
NICE said Roche had submitted a new analysis on a subgroup of patients with the highest levels of HER2 during previous draft guidance.
The data from the subgroup were found to increase median overall survival by 5.6 months with an estimated QALY cost of between £45,000 and £50,000.
The appraisal committee discussed this new information in the context of its end-of-life policy and concluded that Herceptin was cost-effective in this patient group.
Dr Carole Longson, health technology evaluation centre director at NICE, said: “We are very pleased to be able to recommend trastuzumab for patients with gastric cancer who have very high levels of HER2.
“This new guidance is good news for patients. The average life expectancy for people with metastatic gastric cancer is around one year. Although trastuzumab is not a cure, it has the potential to extend the lives of those patients with high levels of HER2 by more than three months.”
HER2 is a protein found on the surface of some cancer cells. Herceptin attaches itself to the protein so that epidermal growth factor production is reduced in the cancer cells, which stops the cells from dividing and growing.
Current treatments for gastric cancer include Roche’s own Xeloda that NICE approved in June as a first line treatment for patients with inoperable, advanced gastric cancer.
NICE blocks Glivec
Meanwhile it was bad news for Novartis as NICE did not recommend Glivec (imatinib) at increased doses to treat gastrointestinal stromal tumours (GISTs) when standard doses have stopped working, due to “insufficient new evidence”.
NICE guidance published in 2004 recommended Glivec at a dose of 400 mg per day to treat GISTs that cannot be removed by surgery.
It also recommends Pfizer’s Sutent (sunitinib) for patients for whom treatment of GISTs with Glivec has not worked or is not suitable.
This review looked specifically at increased doses of Novartis’ drug after treatment with 400 mg had stopped working and considered doses of 600 mg and 800 mg per day.
NICE chief executive, Sir Andrew Dillon, said the independent appraisal committee concluded there have been no further good quality clinical and cost-effectiveness data relating to higher doses since the original appraisal in 2004.
Ben Adams
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