The National Institute for Health and Clinical Excellence (NICE) has issued new draft guidance not recommending the use of three drugs for the treatment of metastatic colorectal cancer that has progressed after first-line therapy.

The drugs are Merck Serono's Erbitux (cetuximab), Roche's Avastin (bevacizumab) and Amgen's Vectibix (panitumumab). NICE has issued the draft guidance for consultation, and says that people who are currently receiving these treatments should have the option to continue therapy until they and their clinicians consider it appropriate to stop.

Commenting on the draft recommendations, NICE chief executive Sir Andrew Dillon said: "metastatic colorectal cancer is when the primary cancer has spread from the colon or rectum to other parts of the body, such as the liver. It can be a devastating disease for both the patient and their family."

NICE has already recommended six treatments for various stages of colorectal cancer and is disappointed not to be able to recommend Erbitux, Avastin and Vectibix at this stage, but it has to be confident that the benefits justify the costs of the drugs, said Sir Andrew.

At present, the independent appraisal committee which drafted the recommendations does not feel it has enough evidence, especially in the case of Avastin, to be able to recommend these drugs for use on the NHS, he added.

"Consultees, healthcare professionals and members of the public are now able to comment on the preliminary recommendations which are available for public consultation. It is also possible for the manufacturers to provide further comment on the committee's interpretation other products' clinical effectiveness or consider reducing the price they are asking the NHS to pay through a patient access scheme [PAS]," Sir Andrew suggested.

No PASs have yet been put forward for any of the three drugs, and NICE also points out that none of the treatments has been approved for second-line use in metastatic colorectal cancer in Scotland.