NICE Recommends Kadcyla for Early Breast Cancer

Nicky Broyd

May 07, 2020

Draft guidance from the National Institute for Health and Care Excellence (NICE) approves trastuzumab emtansine (Kadcyla, Roche) for routine NHS use in England for some patients with HER2 positive primary breast cancer after surgery.  

The drug was already approved for HER2 positive secondary breast cancer.

The charity Breast Cancer Now called the decision "wonderful news".

Positive Trial Results

NICE said evidence from clinical trials shows that in people who still have some cancer cells remaining after chemotherapy to shrink their tumour and HER2-targeted treatment, trastuzumab emtansine increases the time they remain free of disease compared with trastuzumab alone.

The KATHERINE clinical trial found that 88.3% of patients treated with adjuvant Kadcyla after their surgery were free of invasive disease after 3 years, compared to 77% of patients treated with trastuzumab.

Trial data on extending life is not yet available.

Around 800 people will be eligible for the treatment - the average cost of a course of treatment is £51,000 per patient before the confidential NHS discount.

Final guidance is due next month. Wales usually follows NICE decisions while the NHS in Scotland is due to assess the drug later this year.

Breast Cancer Now Chief Executive Baroness Delyth Morgan said in a statement: “It is wonderful news that hundreds of patients with primary breast cancer will now have an additional option to help further reduce the risk of the disease coming back."

She added: "With some cancer treatments currently being delayed or changed due to the coronavirus outbreak, it is important that the option of Kadcyla, and its risks and benefits at this time, is discussed with any eligible patients. The decision to start adjuvant Kadcyla must be made collaboratively with patients, doctors and multidisciplinary teams to ensure the right choice for each person, and it’s vital everyone has the information and support they need."

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