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The National Institute for Health and Care Excellence has approved a potentially life-extending drug combination to treat ovarian cancer.

NICE has recommended olaparib (Lynparza) of AstraZeneca to be used with bevacizumab (Avastin) of Roche for the patients with advanced, high-grade epithelial ovarian, fallopian tube or primary peritoneal cancer.

The drug combination treatment will now be available through Cancer Drugs Fund, following approval by NICE in a draft guidance published today (March 19).

The guidance recommends the new treatment as an option for the patients whose cancer has had a complete or partial response after first-line treatment with platinum-based chemotherapy and bevacizumab. The cancer must also test positive for homologous recombination deficiency (HRD).

Clinical trial evidence suggests that olaparib plus bevacizumab increases the length of time people live before the disease progresses, compared with a placebo plus bevacizumab (37.2 months versus 17.7 months, respectively).

However, clinical trial data is unclear on whether the combination treatment increases overall survival.

“Due to the lack of data on the overall-survival benefit, the cost effectiveness estimates are uncertain so the treatment cannot be recommended for routine use in the NHS,” the draft guidance said.

NICE recognised that olaparib with bevacizumab has the potential to be cost-effective if found to increase survival, and therefore recommended it for use on the CDF. This will allow more evidence to be collected to address the uncertainties around overall survival.

Meindert Boysen, director of the NICE Centre for Health Technology Evaluation, said: “We recognise how important it is to have treatments that postpone disease progression, as they allow people a better quality of life.

“Olaparib with bevacizumab has shown the potential to improve the lives of hundreds of individuals. We don’t yet know whether the benefits on disease progression translate in longer-term outcomes, and we look forward to seeing what the time spent on the CDF will uncover about its benefits for the future.”

Two changes to the current practice will be required to implement the new recommendation –

  • the clinicians will need to introduce testing for HRD
  • will need to offer bevacizumab alongside platinum-based chemotherapy as a first-line treatment.

Clinical experts confirmed it would be possible to implement these changes and the committee took account of the associated costs and consequences in its decision making.

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