A key treatment will become available to women in England who are diagnosed with a particular type of advanced breast cancer, as health officials have given the go ahead for it to be used more widely on the NHS. The new strategic agreement, now will provide the drug published by AstraZeneca and Daiichi Sankyo, to women with HER2-low metastatic breast cancer.
The advice issued by the National Institute for Health and Care Excellence (NICE) is estimated to affect some 1,000 women in the UK. Enhertu was previously rejected for routine NHS funding on the grounds that it was too expensive relative to its benefits.
A New Option for HER2-Low Breast Cancer, HER2 is a protein that is located on the outer surface of some types of tumour cells. When present in high levels in some breast tumours it appears to promote tumour growth. These tumours are known as HER2-positive and can be amenable to specific drugs.
HER2-low breast cancer is different. The cancerous cells contain much less HER2 making them unlikely to respond to former HER2-focused medication the same way. Enhertu is an antibody-drug conjugate, a form of medication that allows chemo to be directly delivered to the cells with the target protein.
The drug is a combination between an antibody that identifies the epidermal growth factor receptor 2 (HER2) and a chemotherapy. Once the drug is attached to a cancer cell, it is taken into the cell where the chemotherapy part (a toxic substance) is released. Its specific targeting is meant to allow the cancer cell to be exposed to treatment without harming the surrounding normal tissue although side-effects can result.
Clinical Trials Show Longer Survival
The choice is based on data from clinical trials indicating that Enhertu can prolong the period during which the patient’s cancer neither relapses nor spreads. In the clinical trials referenced by regulatory agencies and medical coverage, progression-free survivals increased from about 5.1 months with conventional chemotherapy to 9.9 months.
The treatment was also related to an overall survival benefit of a further 6.6 months when compared to chemotherapy traditional treatment. This classed Enhertu as a significant treatment option in patients with metastatic disease and low levels of HER2.
But Enhertu is not a treatment for metastatic breast cancer. It is designed to help prolong life and to try and slow down the progression of the cancer so patients can have a greater quality of life. Treatment decisions will be based on an individuals clinical situation, what treatments they have already had and what a specialist cancer team recommends.
Why Approval Took So Long
In 2024, NICE initially advised against the routine commissioning of Enhertu in England due to its cost effectiveness not being favorable at the price offered by its manufacturers.
