The U.K. National Institute for Health and Care Excellence did not recommend Roche Holding AG's Tecentriq for treating a type of breast cancer due to cost concerns.
The drug price watchdog looked at the use of Tecentriq, combined with chemotherapy, for treating triple-negative breast cancer in adults whose tumors express the PD-L1 protein at a level of 1% or more; whose cancers cannot be removed through surgery and has spread across the body and who have not been given therapy for their metastatic disease.
NICE said its independent committee could not recommend the treatment as a cost-effective use of National Health Service resources due to an unreliable indirect comparison between the Tecentriq combination and the currently utilized treatments.
The U.K. NICE said Tecentriq, or atezolizumab, combined with chemotherapy agent nab-paclitaxel extends the time before the disease worsens — a metric known as progression-free survival — by 2.5 months compared to placebo plus nab-paclitaxel as shown in the late-stage study called IMpassion130. Overall survival, the length of time a patient stays alive with the disease, was also improved by 9.5 months when taking the Tecentriq regimen compared to those given placebo.
However, the agency felt the need for trial data directly comparing the Tecentriq combination and the treatments currently used for the indication — namely, weekly paclitaxel and docetaxel. The U.K. NICE also said Roche's analysis indirectly comparing Tecentriq and chemotherapy with weekly paclitaxel and docetaxel was unreliable and lacked validity.
Tecentriq is part of a class of tumor-targeting drugs called checkpoint inhibitors. The therapy blocks the PD-L1 protein on cancer cells from linking with a partner arm on healthy cells — an interaction that prevents the spread of the disease.
The drug is being examined in clinical trials in other types of cancer, including lung, bladder and skin.
NICE previously recommended Tecentriq combination therapy to treat certain lung cancer patients.
Triple-negative breast cancer is an aggressive form of breast cancer that does not have any of the receptors commonly found in breast cancer — estrogen, progesterone and excess human epidermal growth factor receptor 2.

