Treatment to tackle ‘skeletal-related events’ in some cancer patients gets green light for NHS funding


On 24 October, the UK’s National Institute for Health and Clinical Excellence (NICE) published new guidance which commits the NHS to funding the drug denosumab (Xgeva, Amgen) for cancer patients whose disease has spread from most solid tumour sites (e.g. breast, lung, liver) to their bones. 

The NICE guidance covers the use of denosumab as a treatment to delay or prevent “skeletal-related events” which are caused by bone metastases. These events include pathological fractures, spinal cord compression, or the need for radiation or surgery to the bone. People who are recommended to receive denosumab are those with bone metastases from:

  • Breast cancer or,
  • Solid tumours other than prostate who would otherwise be prescribed bisphosphonates

However, the treatment should only be prescribed on the proviso that the manufacturer makes denosumab available to the NHS under terms agreed with the Department of Health as part of a patient access scheme. The guidance also states that any other patients with bone metastases from other types of solid tumours who are currently receiving denosumab for the prevention of skeletal-related events should continue to receive it until they and their doctor decide that it is appropriate to stop.

“We are pleased to be able to recommend another treatment option for people with bone metastasis from most solid cancer tumours. This type of metastasis can reduce a person’s mobility and quality of life in general, increasing the risk of complications from bone weakness. Denosumab is a welcome addition to the current treatment options available for the people in whom it has been shown to be clinically and cost effective,” saidCarole Longson, director of the Centre for Health Technology Evaluation at NICE.

The guidance is available