The U.K.’s National Institute for Health and Care Excellence said Roche’s breast cancer treatment, Perjeta, is not cost effective for use in patients who have had surgery.

The treatment, which is given with trastuzumab and chemotherapy, is recommended by NICE for treating early HER2-positive breast cancer before surgery and when the cancer has recurred in the breast following initial treatment or has spread elsewhere in the body.

Adding the drug to trastuzumab or chemotherapy had little effect, the institute said, which pointed out a lack of evidence for the drug’s effect on overall survival.

“There was a great deal of uncertainty in the available evidence of clinical effectiveness compared to existing treatments which led the committee to conclude that pertuzumab as adjuvant treatment may not result in meaningful additional benefits for patients,” said Meindert Boysen, director of NICE’s center for technology evaluation.