NICE rejects Tarceva maintenance treatment

Roche’s Tarceva should not be used in lung cancer patients who have already been treated and whose disease remains stable, NICE has ruled.

Tarceva (erlotinib) is already approved by NICE as a first line treatment for non-small cell lung cancer (NSCLC), but is often used as a second line treatment after platinum-based first-line chemotherapy.

Doctors must currently wait for the disease to progress again before they prescribe a second line treatment, whereas a ‘maintenance’ approach would see Tarceva given before this happens.

Roche argues that this earlier treatment can help extend the lives of lung cancer patients by 3.3 months, but NICE is not convinced by the data.

Sir Andrew Dillon, NICE’s chief executive, said: “Erlotinib has been shown to have some clinical benefit, with the manufacturer estimating it can potentially extend life by approximately 3.3 months.

“However, our independent advisory committee felt that a number of assumptions in the manufacturer’s economic model were not appropriate; for example, the overall cost of erlotinib had been underestimated.

“These issues led the committee to conclude that, on current evidence, the cost of the drug related to the benefits it brings means that erlotinib would not be a good use of NHS money.”

The closing date for stakeholder comments on this preliminary appraisal is 7 July.

Andrew McConaghie