NICE has issued final guidance to the NHS not recommending the use of Erbitux (cetuximab), Avastin (bevacizumab) and Vectibix (panitumumab) for the treatment of metastatic colorectal cancer that has progressed after chemotherapy.

Concerns were raised by NICE’s Appraisal Committee surrounding the clinical evidence of the products, especially the use of Avastin.

Sir Andrew Dillon, NICE Chief Executive, says the Institute is “disappointed” not to be able to add the three drugs to the six other recommended options available to the NHS.

No appeals were received on the final draft guidance which did not recommend the treatments after the evidence was considered.

Uncertainness were raised over the data supplied by Roche on Avastin plus non-oxaliplatin chemotherapy of its overall survival gain when used as a second or third-line treatment for those who had not responded to first-line or second-line chemotherapy.

Similar queries were also asked by the Committee of the estimates supplied by Merck Serono on Erbitux plus Campto based on the mixed treatment comparison, and on the magnitude of the survival benefit of Vectibix relative to best supportive care provided by Amgen.

“We have to be confident that the benefits that drugs offer patients really do justify what the NHS will have to pay for them,” said Sir Andrew.

“The independent appraisal committee which drafted the recommendations does not feel it has enough evidence, especially in the case of bevacizumab, to feel confident in recommending these drugs for use on the NHS.”

Campto (irinotecan), Eloxatin (oxaliplatin), Xeloda (capecitabine), tegafur with uracil and Erbitux (cetuximab) have all previously been recommended for various stages of colorectal cancer for use on the NHS.

NICE has failed to recommend a trio of drugs for the treatment of metastatic colorectal cancer that has progressed after first-line chemotherapy in final draft guidance.

Its independent Appraisal Committee deemed there was not enough evidence to recommend the use of Erbitux (cetuximab), Avastin (bevacizumab) and Vectibix (panitumumab).

Sir Andrew Dillon, NICE Chief Executive, said the Institute has to be confident that the benefits that treatments offer to patients justify what the NHS has to pay for them.

Campto (irinotecan), Eloxatin (oxaliplatin), Xeloda (capecitabine), tegafur with uracil and Erbitux (cetuximab) have all previously been recommended for various stages of colorectal cancer.

Uncertainness were raised over the evidence presented by Roche on Avastin plus non-oxaliplatin chemotherapy of its overall survival gain when used as a second or third-line treatment for those who had not responded to first-line or second-line chemotherapy.

Questions were also asked by the Committee of the estimates supplied by Merck Serono on Erbitux plus Campto based on the mixed treatment comparison and on the magnitude of the survival benefit of Vectibix relative to best supportive care provided by Amgen.

“We have already recommended six treatments for various stages of colorectal cancer and are disappointed not to be able to add these three drugs, cetuximab, bevacizumab and panitumumab to the list of treatments for this stage of the disease,” said Sir Andrew.