Liz Hardaker, medical director of Cephalon UK. “We are disappointed and surprised that NICE has not taken this opportunity to distinguish between different forms of anthracycline treatment; specifically the use of liposomal-encapsulated doxorubicin.
“Myocet, in combination with cyclophosphamide, is indicated for the first line treatment of metastatic breast cancer in women (SmPC). A number of published clinical trials have shown liposomal-encapsulated doxorubicin to provide improved safety by reducing cardiac toxicity whilst retaining comparable efficacy compared with conventional doxorubicin1,2.
“For patients previously treated with an anthracycline in early breast cancer, Myocet is more effective than doxorubicin with a significantly higher overall objective response rate (ORR) and significantly improved time to treatment failure (TTF).3
“Anthracyclines are a mainstay treatment of metastatic breast cancer but their use is limited by cumulative dose-related cardiotoxicity and myelosuppression, despite long anthracycline-free intervals in many patients. Liposomal-encapsulated doxorubicin was developed to address these toxicity issues1.
“NICE guidelines play an important part in determining appropriate treatment for patients and the failure of NICE to recognise the place of liposomal-encapsulated doxorubicin in its latest guidance may limit access to a treatment that could provide benefit to eligible patients.”
Justin Stebbing, consultant medical oncologist and senior lecturer at Charing Cross Hospital said: “We have approved the use of Myocet in selected patients with breast cancer at Imperial College Healthcare NHS Trust.
“This is based on the data showing efficacy at least as good as other ‘conventional’ anthracyclines, and a lack of cardiac toxicity which is now particularly relevant, as patients with all forms of breast cancer are living longer.”
1 Batist G et al. J Clin Oncol 2001;19(5): 1444-1454.
2 Harris L, Batist G, Belt R et al. Cancer 2002; 94: 26-36
3 Batist G et al. Anti-Cancer Drugs 2006; 17: 587-595.