NICE has published draft guidelines rejecting Sanofi Genzyme’s Caprelsa for treating medullary thyroid cancer (MTC) that cannot be operated on or has spread around the body.

According to the Institute, while Caprelsa (vandetanib) may delay the disease getting worse compared with best supportive care, “the benefit is uncertain”.

Also, it says evidence about whether the drug increases the overall survival is “unreliable”.

Clinical experts felt Caprelsa is likely to be as effective as Ipsen’s Cometriq (cabozantinib), the only other NICE recommended systemic treatment option for unresectable, locally advanced or MTC, but that cost-effectiveness estimates compared with either cabozantinib or best supportive care “are much higher than what NICE normally considers an acceptable use of NHS resources”.

In addition, the drug does not meet NICE’s end-of-life or Cancer Drugs Fund criteria, and so cannot be recommended as a cost-effective use of NHS resources.

MTC is a rare type of thyroid cancer with around 80 people diagnosed with it each year in England.