A PROMISING treatment for advanced breast cancer has been rejected in a “shattering blow” to patients, as campaigners accused officials of failing women with secondary cancer.
The Scottish Medicines Consortium (SMC) announced its decision to refuse everolimus for use on the NHS yesterday. It is the fourth drug it has refused in the past year for treating women whose cancer has spread to other parts of the body.
The treatment, marketed as Afinitor, can delay the need for chemotherapy by six months and could extend patients’ lives.
SMC chairman Professor Jonathan Fox said it was “disappointing” to reject the drug but there was not enough proof of its clinical benefits.
He added: “We know this decision will be disappointing to both patients and clinicians as we understand the devastating impact of breast cancer.”
Cancer charities have called for an overhaul of the SMC’s Patient and Clinician Engagement (PACE) system, introduced in May 2014 to evaluate end-of-life medicines and drugs to treat very rare conditions.
Mary Allison, director for Scotland at Breast Cancer Now, said: “The SMC’s decision to reject Afinitor is yet another shattering blow to women across Scotland who are living with incurable breast cancer. When it comes to accessing high-cost, innovative medicines for secondary breast cancer, the system is failing women in Scotland.
“We are extremely concerned all four drugs for secondary breast cancer that have been through the new process have been rejected.”
The decision was described as creating a “postcode lottery” for patients, as Afinitor is available in England and Wales but not for the 4,000 women diagnosed every year in Scotland.
Nicolas White, head of Scotland at Breast Cancer Care, said: “The new system is clearly not working for women with incurable breast cancer. Rather than just paying lip service to the views of patients, the Scottish Medicines Consortium and Scottish Government urgently need to review this process - ensuring the patient voice is at the heart of decision making.”
He added: “Women with this incurable disease have seen their treatment options diminish drastically. Not only is this process putting a price on giving someone additional time with loved ones, but it is also denying them this precious time.”The SMC approved six medicines including abiraterone and radium-223 for treating prostate cancer, making Scotland the only UK country to offer both life-extending treatments for the disease.
Radium-223, also known as Xofigo, is used to treat men whose cancer has spread to their bones and can reduce the risk of spinal compression and fractures.
Professor Rob Jones, professor of clinical cancer research and honorary consultant in Medical Oncology at the Beatson West of Scotland Cancer Centre, Glasgow, said: “Around 900 men a year die from prostate cancer in Scotland. In the majority of these men, the cancer will have spread to the bones and this can cause a lot of problems such as pain, fracture and paralysis.
“The availability of radium-223 dichloride is welcome news for men living with advanced prostate cancer and their families as this is a treatment which specifically targets the bones, improving pain control and preventing other complications as well as prolonging survival.”
Another treatment abiraterone, or Zytiga, was initially rejected for men who have not had chemotherapy but this was overturned on review.