PUBLISHED ON: 8 August 2014

The National Institute for Health and Care Excellence (NICE) will not recommend a drug called T-DM1 (Kadcyla) which is used to treat a type of secondary breast cancer for use on the NHS.

Responding to the news Emma Pennery Clinical Director at Breast Cancer Care said: ‘Kadcyla being rejected from routine NHS access will come as another devastating blow to women with HER-2 positive advanced breast cancer denying them the chance of a longer and much better quality of life. Women affected by breast cancer share with us every day their profound anxiety around being able to get access to the treatments they need on top of the already huge emotional burden of living with cancer.

‘Access to best treatment and care for people with advanced breast cancer urgently needs addressing. Worryingly almost every drug appraised by NICE in the last three years for this group of patients has been rejected.’

Secondary breast cancer occurs when cancer cells from the breast have spread to other parts of the body such as the bones lungs liver or brain. While drugs can be used to control secondary breast cancer often for several years it cannot be cured.

What is T-DM1?

T-DM1 (also known as trastuzumab emtansine or by the brand name Kadcyla) consists of two drugs linked together: a targeted therapy called trastuzumab (Herceptin) and a chemotherapy drug called DM1 (also known as emtansine).

It delivers the chemotherapy drug DM1 directly into the breast cancer cells where it can destroy the cancer cells but leave normal cells relatively unharmed. This means that people in clinical trials had fewer side effects than with standard chemotherapy drugs alone.

Find out more about T-DM1 including its potential side effects.

T-DM1 can be used to treat people with HER2 positive secondary breast cancer or regional recurrence (where surgery is not possible) who have already had trastuzumab and chemotherapy drugs called taxanes either together or separately.

Why has NICE decided not to recommend T-DM1?

In a statement NICE said that it was ‘disappointed’ that the drug’s manufacturer Roche ‘has decided not to offer its new treatment at a price that would enable it to be available for routine use in the NHS’.

Roche meanwhile insists that ‘NICE’s rejection comes despite Roche offering to cut the price of the drug’.

NICE’s decision means the drug won’t be routinely prescribed by doctors in the NHS.

T-DM1 may be available through the Cancer Drugs Fund in England. However as Dr Pennery says: ‘The Cancer Drugs Fund enables access to some drugs rejected by NICE but it’s clearly an inadequate solution being an England-only scheme and due to terminate in 2016.

‘NICE the Department of Health and the pharmaceutical industry must work together to identify a new way forward that takes into account both human and economic impact; drugs must be clinically effective and financially affordable but their effectiveness must also be measured on the improved quality of life they offer. Until then women with advanced breast cancer will continue to carry the burden of being denied access to drugs that could prolong and significantly enhance their life.’

Information about secondary breast cancer

You can find more information on treatments for secondary breast cancer and living with secondary breast cancer on our website.

Breast Cancer Care’s free and confidential Helpline is available to anyone with questions about secondary breast cancer – call 0808 800 6000 for more information.