NICE approval for denosumab in cancer

24 October 2012

The osteoclast-targeting antibody denosumab has been accepted for NHS use in patients with bone metastases.

Denosumab targets the RANK ligand, which is essential for the differentiation, function and survival of osteoclasts

Denosumab (Xgeva) is recommended as an option for preventing skeletal-related events in adults with bone metastases from breast cancer and from solid tumours other than of the prostate.

It may be used if:

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

Denosumab is not recommended for preventing skeletal-related events in adults with bone metastases from prostate cancer. Skeletal events are defined as pathological fracture, radiation to bone, spinal cord compression or surgery to bone.

Denosumab is also licensed as Prolia for the treatment of osteoporosis in postmenopausal women and for the prevention of bone loss associated with hormonal therapy in men with prostate cancer. It is accepted by NICE for restricted use in the postmenopausal setting.

NICE guidance on denosumab in adults with bone metastases

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