Adults with cancer that has spread to the bone from solid tumours except for prostate cancer

NICE recommends denosumab as a possible treatment for preventing complications that result from cancer spreading to the bone from solid tumours, except for prostate cancer, if the person would otherwise be prescribed a type of drug called a bisphosphonate.

Adults with cancer that has spread to the bone from prostate cancer

NICE does not recommend denosumab for preventing complications that result from prostate cancer spreading to the bone.

Why has NICE said this?

NICE looks at how well treatments work, and also at how well they work in relation to how much they cost the NHS.

In people with breast cancer that has spread to the bone NICE recommended denosumab because it works better and, because it works better, is likely to cost the NHS less overall than other treatments available on the NHS.

In people with cancer that has spread to the bone from solid tumours, except breast and prostate cancer, NICE recommended denosumab because it works better than bisphosphonates. Although it also costs more than other treatments, this was justified by the benefits it provided.

In people with prostate cancer that has spread to the bone denosumab does not provide enough benefit to patients to justify its high cost so NICE did not recommend it.

Your responsibility

The recommendations in this guidance represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, health professionals are expected to take this guidance fully into account, alongside the individual needs, preferences and values of their patients. The application of the recommendations in this guidance is at the discretion of health professionals and their individual patients and do not override the responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or their carer or guardian.

Commissioners and/or providers have a responsibility to provide the funding required to enable the guidance to be applied when individual health professionals and their patients wish to use it, in accordance with the NHS Constitution. They should do so in light of their duties to have due regard to the need to eliminate unlawful discrimination, to advance equality of opportunity and to reduce health inequalities.

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