The National Institute for Health and Care Excellence (NICE) has recommended that relapsed (second line) non-small cell lung cancer patients no longer have access to cancer pill Tarceva (erlotinib) because it does not meet their criteria for clinical and cost-effectiveness. The decision will set lung cancer care in England and Wales backwards and over 1,000 patients a year will be left without an active treatment option after their first-line therapy has failed while patients in Scotland and the rest of Europe continue to benefit from erlotinib.

Clinicians use erlotinib to treat six out of 10 patients receiving active anticancer therapy for relapsed patients but after re-reviewing its existing guidance, NICE will leave patients with access to only the chemotherapy, docetaxel, which many patients are too sick to tolerate. This will effectively leave these less fit patients with no active treatment option to fight their cancer and goes against NHS England’s policy which states that no patient will be without access to cancer treatment.

Dr Rohit Lal, Consultant Medical Oncologist with Independent Oncology practises in the NHS at Guy’s & St Thomas’ NHS Foundation Trust, London. He comments: “Erlotinib is the only active treatment option for the majority of lung cancer patients who have relapsed after chemotherapy as they are unable to take docetaxel. Careful use of erlotinib by expert clinicians in England will no longer be possible following NICE’s recommendation that access is taken away. Patients and carers in my clinic will question why they do not deserve treatments that may control their cancer.”

International benchmarking studies show that the UK lags behind many other European countries in terms of lung cancer survival rates due to late diagnosis and poor treatment access, amongst other factors. Lung cancer treatment rates in the UK are already low with less than 40% of patients receiving any kind of active treatment when their cancer relapses. The NICE decision would reduce this even further and impact treatment now and in the future, as a significant number of new lung cancer medicines currently in development are designed to be combined with erlotinib.

Clinicians, patients and the public have until 24 February to respond to the preliminary NICE decision. NICE will then publish its final decision in June.

Find out more about Tarceva on the Macmillan website.