The National Institute for Health and Clinical Excellence (Nice) has rejected the use of Avastin for metastatic breast cancer on the NHS.
The decision confirmed Nice's preliminary guidance and said the drug offered limited and uncertain benefit for patients compared with existing treatments.
It is likely to be seen as a boost to health insurers who offer complete cancer coverage including drugs not covered by the NHS, such as Avastin.
Avastin (bevacizumab) was tested working alongside taxane (a type of chemotherapy drug) as a first-line treatment for people with metastatic breast cancer.
An independent appraisal committee which developed the guidance for Nice, considered evidence from the manufacturer, clinical experts and patient and primary care trust representatives.
Clinical trial data suggested that, for breast cancer patients whose tumours have spread elsewhere in the body, bevacizumab (when used with the taxane drug, paclitaxel) may slow the growth and spread of the cancer by around five months more than paclitaxel alone.
However due to uncertainties in the evidence the committee was unable to conclude whether bevacizumab could extend a patient's life, or how long for.
There was also no evidence to show if the drug could offer a better quality of life than existing treatments.
Sir Andrew Dillon, chief executive Nice, said: "The evidence for the effectiveness of bevacizumab in prolonging survival was not robust and overall did not show enough of a demonstrable benefit for it to be considered a cost-effective use of NHS resources.
"Nice is committed to ensuring the most effective and efficient treatments, both for patients and the NHS, are available to those who need them. With this in mind, we already recommend a range of treatment options for patients with metastatic breast cancer in our clinical guideline for advanced breast cancer," he added.
