The National Institute for Health and Clinical Excellence has turned down the use of Roche’s Avastin to treat metastatic breast cancer on the National Health Service on doubts over efficacy.

Preliminary guidance by the cost watchdog has rejected Avastin (bevacizumab) for metastatic forms of the disease because of an “uncertain evidence base” on its survival benefits.

According to the Institute, while clinical trial data showed that the drug could slow the growth and spread of the tumour for five and a half months longer than paclitaxel alone, it only extended overall patient survival by around seven weeks.

Moreover, the appraisal committee also looked at results of a clinical trial (not submitted by Roche) pitting Avastin in combination with the gold-standard therapy docetaxel against doctetaxel alone. While also showing that Avastin can hold back the growth and spread of the cancer, “the results were much less conclusive, raising questions over the true efficacy of [the drug]”, NICE said.

Furthermore, the Institute’s chief executive Andrew Dillon explained that there was no proof that Avastin “can give patients a better quality of life than paclitaxel or docetaxel”. Given these uncertainties, NICE ruled that, at more than £3,000 per patient per month, the drug is simply too expensive “for the limited and uncertain benefit it may offer patients”.

In a statement to the press, Roche said it would respond to the consultation document and “plans to work closely with the Government to explore all possible avenues of making Avastin available to patients in the UK”.