Negative NICE Recommendation for Abraxane in Pancreatic Cancer

NICE (the National Institute for Health and Care Excellence) has issued its Final Appraisal Determination (FAD) on Abraxane (paclitaxel formulated as albumin bound nanoparticles; nab-paclitaxel) in combination with gemcitabine, and has not recommended it for use by NHS England for the treatment of metastatic adenocarcinoma of the pancreas.

In addition, an NHS England review of 42 cancer treatments currently available through the Cancer Drugs Fund (CDF) could result in Abraxane being ‘de-listed’, despite being added to the list earlier this year and the All Wales Medicines Strategy Group (AWMSG) recommending it for use. Abraxane in combination with gemcitabine was added to the CDF in March 2014, following support from 70 leading pancreatic cancer specialists to include it on the list. So far over 260 metastatic pancreatic cancer patients have been able to access Abraxane through the CDF.

Professor Will Steward, Professor of Medical Oncology in Leicester, said: “This is very depressing news for patients with metastatic pancreatic cancer who already have very limited treatment options. This negative NICE decision means that hundreds of patients with metastatic pancreatic cancer, who could potentially benefit from Abraxane, will not have access to it. For a cancer which has such poor survival rates, this is a very sad decision by NICE and now leaves clinicians with limited treatment options.”

Ms Alex Ford, Chief Executive of Pancreatic Cancer UK, said: “This is an extremely worrying time for pancreatic cancer patients and their families. The NICE decision and the review by the CDF which could lead to Abraxane being removed from the CDF, is devastating news for patients with metastatic pancreatic cancer who currently have very few treatment options. Pancreatic Cancer UK calls for NICE to reconsider so that metastatic pancreatic cancer patients in England and Wales are able to benefit from this treatment.”

Ali Stunt, Founder and CEO of Pancreatic Cancer Action, said: “We are outraged that the first licensed and clinically effective treatment for pancreatic cancer in over 7 years has not been approved by NICE. Patients with pancreatic cancer already have a very poor prognosis and limited treatment options. Today’s decision is a backward step by NICE and with the ambiguity surrounding the funding of Abraxane on the CDF, this is an extremely anxious time for future patients with metastatic pancreatic cancer.”

Dr Adrian Kilcoyne, Medical Director, Celgene UK & Ireland, said: “It is very disappointing that NICE did not recommend Abraxane despite the fact they recognised that grounds for end of life could be considered. This decision is a serious setback for both clinicians and patients with metastatic pancreatic cancer.”

“In addition, the potential de-listing of Abraxane from the CDF could mean that patients will not be able to access Abraxane on the NHS in England despite the product in combination with gemcitabine being shown to be clinically effective for previously untreated metastatic pancreatic cancer. We urge NHS England to carefully consider this when decisions are finalised in early January as patients have extremely limited treatment options and the prognosis for pancreatic cancer is so poor, a point which NICE themselves acknowledged in the final appraisal determination.”