New Ovarian Cancer Treatment Option Approved for the CDF

Peter Russell

October 11, 2019

An ovarian cancer treatment, designed to help maintain the effects of chemotherapy, was approved by the National Institute for Health and Care Excellence (NICE) for inclusion in England's Cancer Drugs Fund.

In final draft guidance, an appraisal committee determined that PARP (poly-ADP-ribose polymerase) inhibitor rucaparib (Rubraca, Clovis Oncology) should be an option for maintenance treatment of relapsed, platinum-sensitive high-grade epithelial ovarian, Fallopian tube or primary peritoneal cancer that has responded to platinum-based chemotherapy in adults.

An estimated 1350 people in England could benefit from the treatment.

More Evidence Sought on Overall Survival

Clinical trial evidence suggested that rucaparib prevented cancer progression for twice as long as placebo treatment – a median of 10.8 months in the rucaparib group compared with 5.4 months in the placebo group.

However, NICE initially rejected rucaparib for routine NHS use because of uncertainties in the clinical evidence.

The committee also judged that the treatment was too expensive to be considered cost-effective. Since then, the manufacturer had proposed a price discount.

Inclusion in the Cancer Drugs Fund would allow further data on overall survival to be collected, the committee said.

Confidential Price Discount

Meindert Boysen, director of the NICE Centre for Health Technology Evaluation, said in a statement: "Many people with advanced ovarian cancer experience recurrent disease which requires multiple rounds of chemotherapy. Rucaparib offers patients a new treatment option to help prevent cancer growth, delaying the need for further chemotherapy and the associated side-effects.

"We’re therefore pleased with the positive response from the company that has led to rucaparib being approved for use in the Cancer Drugs Fund. This will allow patients to access the treatment immediately."

John Stewart, NHS director of specialised commissioning, said: "Providing the latest cutting edge treatments for patients through innovative drug deals is just one way the NHS Long Term Plan will transform cancer care across the country."

Rucaparib is taken orally as tablets. The recommended dosage is 600 mg (two 300 mg tablets) twice daily.

The list price for rucaparib is £3562 per 60-tablet pack. A course of treatment was estimated at £110,897.

The size of the discount offered by the manufacturer was not disclosed.

Final guidance is expected on the 13th November.

'An Incredibly Important Development'

NICE recently recommended two other PARP inhibitors for inclusion in the Cancer Drugs Fund. Niraparib (Zejula, Tesaro) was recommended as a maintenance treatment for the same patient group, and olaparib (Lynparza, AstraZeneca) for the BRCA-positive subgroup. 

Annwen Jones, chief executive of charity Target Ovarian Cancer, said: "For too long ovarian cancer treatment options beyond chemotherapy or surgery have been limited, and today’s announcement means that women with ovarian cancer have more choice in their treatment than ever before.

"The fact that women will now have a choice of PARP inhibitors, choosing the treatment best suited to them and their needs, is an incredibly important development."

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