Charity attacks decision not to recommend breast cancer test for use on NHS

Health officials have taken a “backwards step” in breast cancer care after recommending that a genetic test should no longer be used on the NHS, a charity has said.

The Oncotype DX test – which helps to predict the risk of breast cancer recurrence and whether or not a patient would benefit from chemotherapy – was previously recommended for use for certain women on the NHS.

But in new draft guidance, the National Institute for Health and Care Excellence (Nice) said it did not recommend routine use of the test, along with a series of other breast cancer profiling tests, to guide decisions about whether people with certain types of early breast cancer should also have chemotherapy following surgery.

Nice said that “their cost effectiveness compared with current practice is highly uncertain”.

It added that since the previous guidance was published in 2013, NHS clinical practice has changed, with another tool – called PREDICT – now being widely used.

The tool helps women with breast cancer and their doctors make decisions about treatment, and uses data to estimate how a woman may respond to additional treatment.

Baroness Delyth Morgan, chief executive at the charity Breast Cancer Now, said: “Tumour profiling tests like these can help accurately predict the risk of breast cancer returning, aiding doctors and patients in decisions about whether chemotherapy is necessary and enabling some women to safely avoid its gruelling side-effects.

“It’s therefore very disappointing that Nice has been unable to recommend any of these prognostic tools to help guide chemotherapy use on the NHS.

“In particular, this appears to be a backwards step for some patients, for whom guidance published in 2013 previously recommended the use of Oncotype DX. We now look forward to working with Nice to understand the clinical and economic drivers behind this revised recommendation.

“With studies to assess their long-term impacts ongoing, prognostic tests like these are showing real potential to personalise breast cancer treatment and ensure all patients are given the best chance of survival, while reducing overtreatment.

“We very much hope future trial results and further research will soon enable Nice to recommend the best and most cost-effective tumour profiling tests for routine NHS use.”

Dr Emma Pennery, clinical director of Breast Cancer Care, said: “The frustrating decision to block access to all of these invaluable tests on NHS England will halt exciting progress in tailoring treatment to individual patients.”

A spokesman for Genomic Health, which manufactures the test, said: “Since 2013, over 95% of NHS trusts have adopted Oncotype DX and helped more than 16,000 patients benefit from making personalised treatment decisions.

“Access to the test is at risk if the recommendations outlined in Nice’s consultation document remain unchanged.

“This would represent a significant backwards step in breast cancer care for many patients, with more potentially receiving chemotherapy from which they may derive no benefit.

“Nice’s consultation document does not represent final guidance.

“Genomic Health will continue to engage constructively with Nice to further clarify the benefits of the Oncotype DX (test).

“We encourage the medical community, patients and cancer charities to share their concerns with Nice during this open comment period.”

_{Copyright (c) Press Association Ltd. 2018, All Rights Reserved.}