NICE on GSK's Hycamtin in ovarian cancer; to study more cancer, epilepsy

The National Institute for Clinical Excellence has issued guidance onNational Health Service treatment in England and Wales of ovarian cancer with the topisomerase inhibitor Hycamtin (topotecan). The drug, which has been available through the NHS since 1997, was developed by GlaxoSmithKline and is now marketed and distributed in the UK by Merck Pharmaceuticals.

The guidance says the drug should be considered one of the treatment options for women with advanced ovarian cancer if first-line chemotherapy has been unsuccessful. It is not recommended for women with an Eastern Cooperative Oncology Group score of three or below, patients who have an obstruction in their bowel which is caused by the cancer or those who have already been treated with topotecan or another drug of the same type. Response to treatment should be monitored carefully, it says; if there is evidence that the cancer has progressed, the treatment should be stopped, while a reduction in the ECOG may also be a reason to discontinue therapy.

About 360 women in England and Wales already receive topotecan on the NHS, says the NICE. Based on the guidance, it would be prescribed to1,500 more after platinum-based therapy had failed, at a cost to the NHS of about L7 million ($9.9 million) per annum.