Denosumab for the Prevention of Skeletal-Related Events in Adults with Bone Metastases from Solid Tumours (TA265)

Technology Appraisal Guidance No. 265

Source: National Institute for Health and Care Excellence

1. Guidance

1.1 Denosumab is recommended as an option for preventing skeletal-related events (pathological fracture, radiation to bone, spinal cord compression or surgery to bone) in adults  with bone metastases from breast cancer and from solid tumours other than prostate if:

  • bisphosphonates would otherwise be prescribed and
  • the manufacturer provides denosumab with the discount agreed in the patient access scheme.

1.2 Denosumab is not recommended for preventing skeletal-related events in adults with bone metastases from prostate cancer.

1.3 Adults with bone metastases from solid tumours currently receiving denosumab for the prevention of skeletal-related events that is not recommended according to 1.1 and 1.2 should be able to continue treatment until they and their clinician consider it appropriate to stop.

The guidance shown above constitutes Section 1 of the full document. A copy of the full document and a summary of the evidence is available on the Internet at

This guidance represents the view of the Institute which was arrived at after careful consideration of the available evidence. Health professionals are expected to fully take it into account when exercising their clinical judgement. This guidance does not, however, override the individual responsibility of health professionals to make appropriate decisions in the circumstances of the individual patient, in consultation with the patient and/or guardian or carer.

© Copyright National Institute for Health and Care Excellence. All rights reserved. This material may be freely reproduced for educational and not for profit purposes within the NHS. No reproduction by or for commercial organisations is permitted without the express written permission of the Institute.

Enquiries concerning the guidance should be addressed to: National Institute for Health and Care Excellence, MidCity Place, 71 High Holborn, London WC1V 6NA.

Denosumab for the prevention of skeletal-related events in adults with bone metastases from solid tumours
Issue Date: October 2012

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