I remember reading about Avastin a couple of years ago and getting very excited by the whole concept of anti-angiogenesis therapy.
It seemed then - and now - the closest we have come to a cure for cancer. Containing cancer, in all of its forms, in a brilliantly simple way. But of course nothing is ever that easy.
Given that the FDA has removed approval for Avastin due to poor benefit to risk ratio I think this whole issue goes way beyond the penny-pinching accusations that are usually levelled at NICE. Genentech made nearly $3billion out of Avastin in 2008 alone. It is a ridiculously expensive drug that has not proven its efficacy with breast cancer.
Lemongrove - I don't understand the reasoning that anti-angiogenesis drugs may only work before tumours develop. If Avastin were truly effective then in people with mets new tumours would not form and cancer progression would be halted. But it's not - life is extended by an average of only 3 months.
The 2 largest breakthroughs in recent years - Herceptin and Aromatase Inhibitors - both had to prove their worth with metastatic patients before being licensed as adjuvant therapies for primary patients. It makes sense to me that if a drug has genuine potency then its role in metastatic cancer is the primary concern.
Aren't Cameron and co preparing to ditch NICE and establish some cancer slush fund? That should keep the Daily Mail happy.
I am interested to know what these "new drugs" are that are readily available elsewhere. Can anyone provide any details of specific drugs that have been proven to save/prolong life in breast cancer patients but which haven't been licensed here?
Totally agree with Finty. In my view, the evaluation of Avastin has been flawed from the outset. NICE have evaluated it several times now - but on each occasion they have only considered it as an end of life therapy. Unfortunately this misses the real value of Avastin, which is in preventing tumours forming in the first place (by stopping the tumour establishing a vascular system). What's the point of evaluating a drug designed to prevent the formation of tumours, in a person who already has well established and extensive tumours ?.
Britain has the lowest cancer survival rate in the OECD. While there are a number of factors responsible for this, the refusal to fund life-saving drugs and treatments that are readily available elsewhere is important.
I do however agree with MS Molly's comments about wasting valuable resources on the funding of pointless research. When I was first diagnosed with metastatic BC, I changed consultants because I thought his approach to treatment was absolutely useless. A few months later I saw on his website that his special research interest is in using acupuncture for the treatment of breast cancer. I can just imagine all the chemo/rads resistant cancer stem cells falling about with laughter at that one!.
msmolly - I don't disagree with many of you points, but some of the results for Avastin are due to only being licensed in some countries for advanced disease. I believe in the UK it is only available for early metastatic cancer for private patients, and this does tend to skew the results. I have Avastin myself, and my onc had to word the application for it extremely carefully to get the insurance company to approve it.
I don't think access to new drugs is the holy grail. There really isn't some lovely stash of wonder drugs out there that NICE is preventing access to. I think NICE gets a very bad rap.
Avastin has been bumped by regulatory bodies all over the world including the FDA in the US. Avastin simply isn't as effective as its creators made it out to be. Bodies like NICE and the FDA are there to protect us from the claims of the large pharmaceuticals. I don't want NHS money spent on ineffective drugs that give people false hope.
So much of cancer survival depends on early diagnosis. GPs have a HUGE role to play here and this may be where we are lagging behind. I know that cancer specialists are enormously frustrated by late referrals from GPs.
Also there needs to be greater awareness amongst the whole population - people need to take responsibility for their own health. (Smoking, obesity, alcohol - the usual culprits.) Nobody looking at our population as a whole could ever describe it as healthy.
British men are notoriously bad about their health - they vist the GP 20% less than women.
I am always a little wary of comparative studies between different nations as we don't all measure our cancer in the same way. For example we don't include DCIS and other pre-cancers in our cancer figures - other coutries do which means they will appear to have better overall survival rates because they have included non life-threatening cancers in the first place.
I agree that women with secondaries get very erratic quality of care. And women who are TN seem to be constantly overlooked in R&D.
What this study reveals is how badly the over 65s fare in comparison to their peers in other cultures. That, I think, is a damning indictment of our society that simply doesn't give a damn about the older population.
Personally I would like to see less money being poured into the peripheral stuff related to cancer and more going directly into research for cures. People are raising millions to try and stop this disease and it makes my blood boil to see money getting syphoned off for pointless research projects into whether reiki is good for lymphoedema etc.
I have signed a couple of e petitions on this subject but I would be very interested in helping with campaigning. I live in the sticks so getting places is difficult for me but writing letters etc is fine.
I just noticed this headline on the BBC News, Im not sure how to post a link so not sure if this works!
Anyway it is basically saying that the UK lags behind on BC survival compared to other developed countries such as Canada, Australia, Sweden, Norway, Denmark and the UK (not including Scotland).
I personally feel that treatment for primary BC is very good in the UK as long as you get into the system relatively quickly and not subject to delays like lost notes etc.
From speaking with affected friends and reading some posts on this site it seems to me that treatment for secondary BC varies enourmously? It makes me so angry and frustrated that our secondary ladies either don't have access to the new targetted therapies or they have to fight to the end to get them. I notice NICE (?nasty)
rejected the use of Avastin only recently.
In my opinion the reason why the UK lags behind in survival has alot to do with access to new drugs. I would be interested to hear of the experience of others. It's something I feel deeply passionate about and want to do something to make a difference. Is anyone out there campaigning for better access to drugs? I am already a local rep for Breakthrough.