Bayer’s Vitrakvi (larotrectinib) has been rejected by The National Institute for Health and Care Excellence (NICE), as at its current price, it doesn’t have the “potential to be cost-effective.”

The guidance service published the decision in regards to the drug being used in advanced neurotrophic tyrosine receptor kinase (NTRK) fusion-positive solid tumours in adults and children who have no satisfactory treatment options.

The organisation, however, encourages further data collection on similar “game changing” histology independent cancer drugs, with Meindert Boysen, director of the centre for health technology evaluation saying that the meds are “an exciting new development in cancer care.”

Another histology independent treatment, Roche’s entrectinib, which NICE is also appraising could become the first histology independent treatment to be available to patients, provided it receives its marketing authorisation.

NICE also revealed that around 600–700 people have solid tumours with NTRK gene fusions and that a proportion of these people, who have no satisfactory treatment options, will be eligible for one of these therapies within the first year that they’re available on the NHS.

Meindert went on to say, “These cutting-edge therapies target rare genetic mutations, so the clinical evidence is usually based on extremely small sample sizes, requiring novel approaches to testing them in clinical trials. Therefore, further data collection is likely to be needed, for example through the Cancer Drugs Fund (CDF).”

Histology independent cancer drugs target all solid tumours with a certain genomic mutation, regardless of where the primary tumour is in the body.

They are one of the three priority categories of early-stage focus for the Accelerated Access Collaborative, a cross-sector partnership aimed at accelerating access to transformative health technologies, of which NICE is one of the partners.