NICE Issues Trio of Updates Spanning AI-Assisted Cancer Detection, Sepsis Care Pathways, and Breast Cancer Drug Appraisal
The UK’s National Institute for Health and Care Excellence (NICE) has released three significant updates this week, reflecting advances and in one case, limitations across diagnostics, clinical care pathways, and oncology drug access. The announcements cover the conditional rollout of AI tools for bowel cancer polyp detection, updated sepsis treatment guidance, and the termination of a technology appraisal for trastuzumab deruxtecan in hormone receptor–positive, HER2-low metastatic breast cancer.
Together, the updates highlight the breadth of NICE’s evolving regulatory and clinical agenda as the NHS pushes forward with earlier cancer detection, more individualized acute care, and improved transparency around drug cost-effectiveness.
What You Need To Know
- NICE conditionally recommends five AI tools to enhance polyp detection during colonoscopy, supporting earlier bowel cancer prevention.
- Updated sepsis guidance introduces more tailored fluid-management protocols and prioritizes equitable assessment for at-risk patients.
- NICE terminates appraisal of trastuzumab deruxtecan for HER2-low metastatic breast cancer after manufacturer declines to submit evidence.
AI Tools Conditionally Recommended to Enhance Bowel Cancer Polyp Detection
NICE has conditionally recommended five AI-powered polyp-detection technologies to support clinicians during colonoscopy, offering what officials describe as a “second pair of eyes” to help spot potentially cancerous growths earlier. The tools CAD EYE, ENDO-AID, EndoScreener, GI Genius, and MAGENTIQ-COLO analyze live endoscopy video feeds and flag visual features suggestive of polyps.
Under the conditional recommendation, the technologies may be used while additional evidence is collected over the next four years to better understand long-term clinical impact and cost-effectiveness.
Bowel cancer is the UK’s fourth most common cancer, with 42,000 cases diagnosed annually. Earlier detection dramatically improves outcomes: 9 in 10 patients survive when the disease is found at its earliest stage. By alerting clinicians to polyps that may otherwise be missed, the AI systems aim to reduce the number of patients who progress to invasive cancer.
“These tools act like a helpful assistant during bowel examinations,” said Dr. Anastasia Chalkidou, HealthTech Programme Director at NICE. “We’re allowing these technologies to be used now because they show real promise, whilst we gather the detailed evidence we need.”
Government health leaders called the move a key step toward an “AI-enabled NHS,” aligning with the UK’s 10-Year Health Plan to shift care toward earlier detection and prevention.
Updated NICE Sepsis Guideline Recommends More Tailored Fluid Treatment and Better Support for At-Risk Patients
In another major update, NICE has published a newly revised guideline for suspected sepsis in people aged 16 and over, recommending a more individualized approach to care, including smaller initial IV fluid volumes and continuous reassessment after every infusion. The move aims to prevent both under-resuscitation and harmful fluid overload two common complications in critically ill patients.
Sepsis affects at least 245,000 people annually in the UK, with up to 200,000 hospital admissions linked to the condition. Despite national improvement efforts, sepsis remains one of the country’s most life-threatening medical emergencies.
The updated guideline also includes explicit recommendations to ensure equitable assessment for people who may struggle to communicate symptoms effectively. This includes patients with neurodiversity, cognitive impairment, learning disabilities, mental health conditions, brain injury, and individuals for whom English is not a first language.
“We have acted on feedback to ensure that our sepsis guidelines provide the information people need in a readily accessible way,” said Professor Jonathan Benger, NICE’s Chief Medical Officer.
NICE also plans to begin further updates focused on maternal and pediatric early-warning scores, acknowledging evolving science in early deterioration detection.
NICE Terminates Appraisal for Trastuzumab Deruxtecan in HER2-Low Metastatic Breast Cancer After No Company Submission
NICE has terminated its appraisal of trastuzumab deruxtecan for adults with hormone receptor–positive, HER2-low metastatic breast cancer who have previously received at least two endocrine therapies. The termination occurred because Daiichi Sankyo UK declined to submit evidence, telling NICE it does not believe the drug is likely to be cost-effective for the NHS in this particular setting.
Without a company submission, NICE cannot complete the comparative clinical and economic analysis required for a formal recommendation.
NHS organizations may still consider trastuzumab deruxtecan on a local decision-making basis, following the NHS Constitution and Commissioning Board regulations. NICE states it will revisit the appraisal if the company chooses to make an evidence submission in the future.
While not unusual, terminated appraisals underscore the economic complexity surrounding oncology therapeutics particularly when used beyond their highest-value indications.