NICE has published new draft guidance which recommends that nab-paclitaxel taken with gemcitabine hydrochloride should not be funded by the NHS for previously untreated metastatic pancreatic cancer, because it has limited benefits compared to current treatments and it is more costly.

Nab-paclitaxel, which is taken with gemcitabine hydrochloride, is also known as Abraxane and is marketed by Celgene. It is a novel formulation of paclitaxel, a chemotherapy which works by blocking cell division and promoting cell death. In this formulation, paclitaxel is attached to albumin which helps it move through the walls of blood vessels. NICE is currently looking at how well nab-paclitaxel, taken with gemcitabine hydrochloride, works for people whose pancreatic cancer has spread and who have not received any other treatments.

In the early stages, pancreatic cancer doesn't usually cause any symptoms, which can make it difficult to recognise and means that many people are not diagnosed until the cancer is very advanced. Without treatment, survival may be only 2 to 6 months. Some people may be offered a chemotherapy treatment called FOLFIRINOX (a combination of fluorouracil, leucovorin, irinotecan and oxaliplatin), which is the current standard of care for people who are not too poorly to receive it, but this treatment has serious side effects which means it is not always an appropriate option. When this is the case gemcitabine hydrochloride (recommended by NICE in 2001) is generally used, or gemcitabine hydrochloride taken with capecitabine.

For more details, go to: https://www.nice.org.uk/News/Press-and-Media/the-cost-of-nab-paclitaxel-is-not-justified-by-its-limited-benefit-says-nice-in-draft-guidance