We are very pleased that the outcome of the NICE Cancer Drugs Fund Rapid Reconsideration of bosutinib has resulted in a positive recommendation for its routine use in the NHSE in England for all the treatments it has a license for. In detail, bosutinib is now recommended as a treatment for adult patients in England in all three phases (chronic, accelerated and blast) of CML, provided they have been previously been treated with one or more TKIs and where imatinib (Glivec), nilotinib (Tasigna) or dasatinib (Sprycel) are not considered appropriate treatment options.
This rather convoluted language is designed to introduce considerable flexibility into your doctor’s decision making as to which TKI would suit a particular patient and which TKI a patient would feel best suited them.
If the wording is unpicked, it would be possible for bosutinib to be a second line treatment for CML after an initial treatment with either imatinib or nilotinib.
However, clinicians present at the NICE committee meeting stressed that bosutinib would be much more likely to be prescribed as a third or even fourth line TKI treatment.
For those who follow the detail closely, I will post a more lengthy in depth comment at some point over the next couple of days.
For now I’d just like to thank the patient who attended the Committee meeting who spoke so eloquently, cogently and succinctly about his experiences, not just with bosutinib but also with the other TKIs he has been treated with.
We owe so much to all the patients who volunteer to participate in this process. Without them our task would be so much more difficult.
We expect the NICE Committee Rapid Reconsideration meeting for 1st or 2nd line dasatinib treatment to be held in late September this year. We are hopeful that a positive recommendation for both treatment lines will be the outcome of that meeting.
David Ryner
Read the NICE press release: https://www.nice.org.uk/news/article/nice-approves-first-drug-from-old-cancer-drugs-fund#.V35OhXrx6UQ.email
