Roche - Herceptin: NICE OK's use in early breast cancer

Proof that they can and do say "yes" sometimes.

The National Institute of Health and Clinical Excellence (NICE) has published a technology appraisal on the use of Herceptin in early breast cancer.

NICE recommend that it is given to women with early stage HER2-positive breast cancer after they have had surgery and chemotherapy (and radiotherapy if appropriate). It should be given every three weeks for a period of twelve months or until the breast cancer returns, which ever is sooner, provided that the patient has good cardiac function.

Before treatment is started cardiac function should be assessed. Treatment should not be offered if the patient has:

a left ventricular ejection fraction (LVEF) of 55% or less
a history of documented congestive heart failure
high-risk uncontrolled arrhythmias
angina pectoris requiring medication
clinically significant valvular disease
evidence of transmural infarction on electrocardiograph (ECG)
poorly controlled hypertension

NICE also recommend that cardiac assessments are carried out every 3 months and treatment suspended if LVEF drops below 50% or by 10% from the baseline.

Source: Prescribing Advice for GPs.

Insider's view: NICE have made some difficult decisions recently, both positive and negative. IMHO they have been the correct ones.