Herceptin is already approved in breast cancer in certain situations but Tyverb has not yet been through Nice for any other use.
Sir Andrew Dillon, Chief Executive of Nice said: ?Having reviewed the available evidence, our committee of experts has found that while both lapatinib and trastuzumab can reduce the growth and further spread of metastatic breast cancer tumours when taken alongside the aromatase inhibitors letrozole and anastrozole, the extent that these treatments can improve overall survival appears to be small or undefined.
?Furthermore, independent economic analyses indicate that both treatment combinations do not appear to be cost effective for the NHS because they have uncertain clinical benefits for the price that the NHS is being asked to pay.
"Confidence about the additional benefits new treatments bring is important both for patients and for those who have responsibility for managing the resources available to the NHS.
?We have published this draft guidance on our website as an opportunity for stakeholders and the public to contribute to its development.?
The draft guidance said women treated with Tyverb lived one month longer on average but that this was uncertain while those treated with Herceptin lived 6.5 months longer but this too was uncertain.
Until the Nice guidance is finalised, local NHS bodies will continue to decide whether the fund the drugs on a case-by-case basis.
Dr Sarah Rawlings, Head of Policy and Public Health at Breakthrough Breast Cancer said: ?There is a real need for more targeted and effective treatment options for this small group of breast cancer patients.
"It?s vital to find the right drug combinations for the right patients and we are disappointed that Nice are unable to recommend these treatments. It?s important to remember that this is draft guidance and we?ll continue to work with Nice.
"We encourage anyone who is concerned about their treatment options to speak to their doctor.?
Carolyn Rogers, Clinical Nurse Specialist at Breast Cancer Care said: ?Whilst evidence suggests that the clinical benefit of this drug combination may be very small, even a minor clinical benefit can be extremely important for the patient, and this is especially the case for people living with secondary (advanced) breast cancer, whose treatment options are limited."
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