Roche's new 'smart pill' Xeloda has been recommended by NICE for the treatment of advanced breast and bowel cancer.

The recommendations are the latest in a series of cancer drug appraisals by NICE, which it says will combine to form part of a wider set of clinical guidelines for the treatment and care of cancer patients.

Xeloda (capecitabine) is recommended for the treatment of locally advanced and metastatic breast cancer in combination with docetaxel (Aventis' Taxotere) when anthracycline treatment has failed or is unsuitable.

It can also be used as a monotherapy when treatment with either anthracycline or taxane has failed.

For colorectal cancer, Xeloda is recommended as a first-line treatment with uracil. Tegafur (Bristol-Myers Squibb's Uftoral) has also been recommended for the same indication.

Xeloda is available as a pill, as opposed to traditional hospital-administered chemotherapy, meaning patients require fewer hospital visits.

The drug is activated by the enzyme thymidine phosphorylase, which is present at higher levels in cancerous cells than in normal cells, which results in fewer side-effects than traditional chemotherapy.

NICE said there should be "informed discussions" between patients and clinicians about treatment options before a joint decision is made. Martin Ledwick, Senior Cancer Information Nurse at Cancer BACUP, said this showed a "real commitment" to involving patients in decisions affecting their own healthcare.

Jola Gore-Booth, Chief Executive of Colon Cancer Concern, said NICE's recommendations were "excellent news".

"We know from our discussions with patients who have taken oral chemotherapy, that there is strong support for this form of treatment", she said. "Patients find oral chemotherapy convenient and easy to take; that the treatment has fewer side effects than they expected; and that it enables them to live fuller and more normal lives".

Breast and colorectal cancer are two of the most common cancers in the UK, with around 64,000 new cases diagnosed each year in England and Wales.

Xeloda was first approved for breast cancer in the US in April 1998, with European approval coming in March 2002. Colorectal cancer approval was granted in Europe in February 2001 and in the US in May 2001.

Global sales in 2002 were CHF444 million (£207.8m), a rise of 82% on the previous year.

pharmafocus@pharmafile.co.uk