The UK’s National Institute for Health and Care Excellence (NICE) has recommended the use of Roche’s Perjeta (pertuzumab) by the National Health Service (NHS) to treat early HER2-positive breast cancer, which has spread to lymph nodes.

The recommendation covers the use of pertuzumab along with trastuzumab and chemotherapy in patients who have had surgery for their breast cancer and whose cancer has already spread to their lymph nodes.

It comes after the Swiss healthcare company agreed to offer an improved discount for the drug.

In August last year, the cost-effectiveness watchdog recommended against the use of the drugsaying that the clinical effectiveness of the pertuzumab combination in preventing disease recurrence after surgery is uncertain.

NICE also previously stated the cost-effectiveness estimates of the drug were too high, considering Roche’s predictions of overall survival in patients.

In its latest guidance, NICE noted that pertuzumab in combination with trastuzumab and chemotherapy significantly increased the proportion of patients whose disease didn’t spread in clinical studies.

"We’re pleased that we’ve been able to work with the company to address the uncertainties of pertuzumab as a treatment for early HER2-positive breast cancer."

However, evidence is still required on how long, if at all, adding Roche’s drug may increase the overall survival.

After the company proposed an improved discount and submitted a revised economic analysis of patients whose cancer had spread to their lymph nodes, the cost-effectiveness estimate for pertuzumab is now said to be within the range that NICE considers to be a good use of NHS resources.

NICE Centre for Health Technology Assessment director Meindert Boysen said: "We’re pleased that we’ve been able to work with the company to address the uncertainties of pertuzumab as a treatment for early HER2-positive breast cancer.

"Their response means that people who have a high risk of their cancer returning now have a new treatment option that could reduce the risk of that happening."

NICE had previously recommended this drug combination for early HER2-positive breast cancer before surgery,  in cases where it has recurred in the breast after initial therapy or has spread from the breast to elsewhere in the body.

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