National Institute for Health and Clinical Excellence (NICE)
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NICE draft guidance recommends abemaciclib for advanced breast cancer

NICE has today (12 August 2021) published draft guidance which recommends twice-daily pill abemaciclib (also called Verzenios and made by Eli Lilly) as an option for adults with a type of breast cancer called hormone receptor-positive, HER2-negative breast cancer which has spread to other parts of the body.

The positive recommendation follows an improved patient access scheme from the company. This, taken together with further economic modelling data provided by the company, means that abemaciclib can now be recommended as a cost-effective use of NHS resources.

Abemaciclib is a drug called a CDK4/6 inhibitor and works by blocking proteins in cancer cells which allow the cancer to divide and grow. It is given with the hormonal therapy drug fulvestrant in adults who have had hormonal therapy.

During consultation on the previous draft recommendations the committee heard further of the value to patients of having abemaciclib as a further treatment option. This is because it is an alternative CDK4/6 inhibitor to others currently available and has different side effects. Having this option is useful to help manage the side effects associated with these drugs.

NICE’s draft guidance means abemaciclib will now come out of the Cancer Drugs Fund and be made available routinely as an option where exemestane plus everolimus would be the most appropriate alternative treatment to a CDK 4/6 inhibitor. It is estimated that around 2,500 people could be eligible for treatment with abemaciclib under this guidance.

Meindert Boysen, director of the Centre for Health and Technology Evaluation at NICE, said: “Advanced breast cancer is an incurable condition and the aim of treatment is to delay it getting worse and extend survival. The committee heard that CDK4/6 inhibitors like abemaciclib were welcomed by patients because they can delay the time before their cancer gets worse and so delay or avoid the need for chemotherapy.

“The committee also heard from the patient experts that exemestane plus everolimus, the treatment that would normally be used at this stage, was poorly tolerated and used for only a small number of people because it has similar effects to chemotherapy on quality of life. We are therefore very pleased to be able to recommend that abemaciclib with fulvestrant can now be provided routinely as another option for people with advanced breast cancer who have already had endocrine therapy.”

NICE expects to issue its final guidance on abemaciclib given with fulvestrant for hormone receptor-positive, HER2-negative metastatic breast cancer in September.

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