NICE issues final guidance on the use of cetuximab for the treatment of head and neck cancer

NICE issues final guidance on the use of cetuximab for the treatment of head and neck cancer

The National Institute for Health and Clinical Excellence (NICE) has today (24 June) published guidance on cetuximab for the treatment of recurrent and/or metastatic (where the cancer has spread) squamous cell cancer of the head and neck. The guidance does not recommend cetuximab in combination with platinum- based chemotherapy as a treatment option for patients with this type of head and neck cancer.

The cells that line parts of the body like the mouth and nose are called the ‘epithelium'. Squamous cell cancer of the head and neck is cancer of the epithelium of the mouth, nose, throat and surrounding areas.

People currently receiving cetuximab in combination with platinum-based chemotherapy for the treatment of recurrent and/or metastatic squamous cell cancer of the head and neck should have the option to continue treatment until they and their clinician consider it appropriate to stop.

Andrew Dillon, NICE Chief Executive said: "When reaching today's decision the appraisal committee took account of all of the available evidence on the use of cetuximab, in combination with platinum-based chemotherapy, when compared to the existing treatment options already available to patients with metastatic squamous cell head and neck cancer. The committee noted the existing uncertainty over the clinical effectiveness of the treatment and the costs of the treatment when compared to those currently available. The manufacturer's cost-effectiveness analysis resulted in the cost of an additional ‘quality adjusted life year' - (the equivalent cost of providing one additional year of healthy life) - from treatment with cetuximab plus platinum-based chemotherapy compared with platinum-based chemotherapy alone to be £121,367 with a predicted gain in overall survival of just over two  months. This would mean the NHS making significant funds available for a very expensive treatment which may or may not benefit individual patients. Those funds would not then be available for treating other conditions with greater and more certain benefits for other patients.

The Committee also took into account the supplementary advice provided by NICE to be taken into account when appraising treatments at the end of life. The Committee noted that Cetuximab was used for a small population with a short life-expectancy for a devastating disorder but it did not offer sufficiently greater  benefits to these patients compared to existing treatments."

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