Targeted breast cancer treatment approved for NHS use in England

A new treatment for early stage breast cancer will be made available for certain patients on the NHS in England.

Following the recommendation from the National Institute for Health and Care Excellence (NICE), neratinib (Nerlynx) will be offered as an extended treatment for breast cancer patients who’ve had another targeted treatment, trastuzumab (Herceptin), within the last year.

The new treatment is said to “significantly reduce the proportion of breast cancer relapses”, according to short-term trial data.

A new targeted option

Neratinib blocks the cancer growth by interfering with chemical signals sent between cells.

It’s recommended for patients whose cancer tests positive for hormone receptors and a molecule called HER2. The treatment will only be available to adults who’ve been treated with trastuzumab within the last year, and where trastuzumab was used after initial treatment to help stop their cancer coming back.

This is the first treatment available for patients who have previously taken trastuzumab that maintains the intended effect of the drug (adjuvant therapy).

Further criteria which patients will have to meet in order to access the drug include:

• Trastuzumab is the only treatment they’ve taken that targets the molecule HER2.
• If trastuzumab was given before surgery, there were still signs of cancer in the tissue samples removed during surgery.

Reducing relapse

Evidence from the ExteNET trial shows neratinib lengthens the time before someone’s cancer comes back.

During clinical trials, half of the 2816 patients took neratinib after chemotherapy and trastuzumab, while the other half were given a dummy drug (placebo).

Of the women taking neratinib, 90 in 100 were estimated to be disease-free at the five-year follow up, compared to 88 in 100 women taking the placebo.

Side effects of neratinib include diarrhoea, nausea, vomiting and fatigue among others. Clinical experts reported that hospital visits may be required to treat diarrhoea.

Rose Gray, Cancer Research UK’s policy manager said: “It’s good to hear that neratinib will now be available for people with this type of breast cancer.

“Clinical trial results showed using the drug in this way reduced the chance of the disease coming back, but it’s still too early to tell for sure whether this means those patients will live longer.”

It’s not known if neratinib increases the overall length of survival because the final trial results are not yet available.