Merck KGaA has been boosted by the news that the National Health Service’s cost watchdog has recommended Erbitux for use in treating some colon cancer patients.

The UK’s National Institute for Health and Clinical Excellence has published a final appraisal determination recommending the use of Erbitux (cetuximab) in combination with chemotherapy as a first-line treatment for metastatic colorectal cancer. However it will only be available for patients who have already undergone surgery, and whose disease has spread only to the liver and who have normal or ‘wild-type’ KRAS tumours.

The FAD also notes that patients can only receive Erbitux for “no more than 16 weeks” and after that, a reassessment will be necessary. The drug works in some 60%-65% of the two-thirds of bowel cancer patients who have KRAS tumours.

Wolfgang Wein, executive vice president of oncology at the German firm’s Merck Serono division, noted that “this is the second positive NICE recommendation for Erbitux in the last 12 months”, after it was backed, alongside radiotherapy, as a treatment for locally-advanced head and neck cancer.

He added that this represents “really positive news for metastatic colorectal cancer patients in the UK – especially as Erbitux is the only targeted therapy endorsed by NICE for the first-line treatment of the disease”. Dr Wein went on to say that “we strongly believe that personalising cancer care by tumor type through KRAS testing at diagnosis is essential in order to provide patients with the best possible outcomes – such as potentially curative surgery – while offering healthcare providers the most efficient use of resources”.

The latter is a major point as Merck is offering a 16% rebate to the NHS on the cost of cetuximab per patient who meets the criteria. The number of patients who will benefit is expected to be 2,000-4,000 out of the 36,000 diagnosed with bowel cancer each year.

Peter Littlejohns, clinical and public health director at NICE, said that before making these draft recommendations, “the appraisal committee took into account the manufacturer's cost-effectiveness estimates and the proposed 16% rebate scheme, as well as the evidence on cetuximab successfully shrinking liver metastases enough so that they can be removed via surgery”.

The committee concluded that “under the specific circumstances outlined in the guidance the cost of cetuximab in relation to how well it works is an effective use of NHS resources”. The recommendation was welcomed by Ian Beaumont, campaigns director at Bowel Cancer UK, who said “we hope that this positive ruling by NICE heralds a new era in the treatment of the disease”.