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Cancer: Drugs

Volume 462: debated on Tuesday 10 July 2007

To ask the Secretary of State for Health which cancer drugs have been referred to the National Institute for Health and Clinical Excellence for appraisal; what the date of (a) referral and (b) where applicable, the decision was of each; which drugs were (i) approved and (ii) not approved; and which type of cancer each drug treated. (146760)

Published technology appraisals from the National Institute for Health and Clinical Excellence (NICE) have decisions which are grouped into three categories:

where the treatment(s) is recommended for routine use in the national health service;

where the treatment(s) is recommended for selective use in the NHS (i.e. for certain patients, after other treatments have failed etc); and

where the treatment(s) is recommended for use in research only or is not recommended.

The following table lists all the technology appraisals relating to cancer treatments published by NICE to the end of June 2007, including the date of referral, the condition and the drugs appraised, the date the guidance was published, the number of the appraisal (TA#) and the decision.

TA#

Condition and drugs appraised

Referral date

Publication

Recommendation

3

ovarian cancer—paclitaxel (Taxol)

4 November 1999

May 2000

Selective

6

breast cancer—docetaxel (Taxotere), paclitaxel (Taxol)

4 November 1999

June 2000

Selective

23

recurrent malignant glioma—temozolomide (Temodal)

12 July 2000

April 2001

Selective

25

pancreatic cancer gemcitabine (Gemzar)

12 July 2000

May 2001

Selective

26

lung cancer (non-small cell)—paclitaxel (Taxol), docetaxel (Taxotere), gemcitabine (Gemzar), vinorelbine (Navelbine)

12 July 2000

June 2001

Routine

28

ovarian cancer (advanced)—topetecan (Hycamtin)

12 July 2000

August 2001

Selective

29

chronic lymphocytic leukaemia—fludarabine (Fludara)

12 July 2000

September 2001

Routine

30

breast cancer—docetaxel (Taxotere), paclitaxel (Taxol)

Review of TA06 12 July 2000

September 2001

Selective

33

colorectal cancer (advanced)—irinotecan (Campto), oxaliplatin (Eloxatin), raltitrexed (Tomudex)

12 July 2000

March 2002

Selective

34

breast cancer (advanced)—tratuzumab (Herceptin)

12 July 2000

March 2002

Selective

37

non-Hodgkin's lymphoma—rituximab (MabThera)

12 July 2000

March 2002

Selective

45

ovarian cancer—pegylated liposomal doxorubicin hydrochloride (Caelyx)

12 March 2001

July 2002

Selective

50

chronic myeloid leukaemia—imatinib (Glivec)

12 March 2001

September 2002

Routine

54

breast cancer (advanced)—vinorelbine (Navelbine)

12 July 2000

December 2002

Selective

55

ovarian cancer—paclitaxel (Taxol)

Review of TA03 12 July 2000

January 2003

Routine

61

colorectal cancer (Metastatic)—capecitabine (Xeloda), tegafur with uracil (Uftoral)

31 July 2001

May 2003

Routine

62

breast cancer (locally advanced)—capecitabine (Xeloda)

31 July 2001

May 2003

Routine

65

aggressive non-Hodgkin's lymphoma—rituximab (MabThera)

20 May 2002

September 2003

Selective

70

chronic myeloid leukaemia—imatinib (Glivec)

Review of TA50 20 May 2002

October 2003

Selective

86

gastro-intestinal stromal tumours (GIST)—imatinib (Glivec)

31 March 2003

October 2004

Selective

91

ovarian cancer (advanced)—paclitaxel (Taxol), pegylated liposomal doxorubicin hydrochloride (Caelyx), topotecan (Hycamtin)

Review of TA28, TA45 and TA55

May 2005

Selective

93

colorectal cancer (advanced)—irinotecan (Campto), oxaliplatin (Eloxatin), raltitrexed (Tomudex)

Review of TA33 1 April 2005

August 2005

Selective

100

colon cancer (adjuvant)—oxaliplatin (Eloxatin), capecitabine (Xeloda)

21 June 2004

April 2006

Routine

101

prostate cancer (hormone refractory)—docetaxel (Taxotere)

21 June 2004

June 2006

Routine

107

breast cancer (early)—trastuzumab (Herceptin)

21 July 2005 (transferred to STA programme November 2005). Licence granted for use in early breast cancer May 2006

August 2006

Selective

108

breast cancer (early)—paclitaxel (Taxol)

5 April 2005 (transferred to STA programme November 2005)

September 2006

Not recommended

109

breast cancer (early)—docetaxel (Taxotere)

5 April 2005 (transferred to STA programme November 2005)

September 2006

Routine

110

follicular lymphoma—rituximab (MabThera)

5 April 2005 (transferred to STA programme November 2005)

September 2006

Routine

112

breast cancer (early)—anastrozole (Arimidex), exemestane (Aromasin), letrozole (Femara)

21 June 2004

November 2006

Routine

116

metastatic breast cancer—gemcitabine (Gemzar)

5 April 2005 (transferred to STA programme November 2005)

January 2007

Selective

118

metastatic colorectal cancer—bevacizumab (Avastin) and cetuximab (Erbitux)

21 June 2004

January 2007

Not recommended

119

chronic lymphocytic leukaemia—fludarabine (Fludara)

Review of TA29 5 April 2005 (transferred to STA programme November 2005. Deferred July 2006 awaiting Medical Research Council trial)

February 2007

Not recommended

121

glioma (newly diagnosed and high grade)—carmustine implants (Gliadel) and temozolomide (Temodal)

21 June 2004

June 2007

Selective

There are also a number of appraisals of cancer drugs on NICE's work programme on which guidance has not yet been issued. The following table lists all the technology appraisals relating to cancer treatments, including the date of referral, the condition and the drugs appraised, whether they are being appraised as a Single Technology Appraisal (STA) or Multiple Technology Appraisal (MTA), the status of the appraisal and where available the expected date of issue.

STA/MTA

Condition and drugs appraised

Referral date

Status

Expected date of issue

STA

breast cancer (advanced or metastatic)—lapatinib (Tyverb)

19 December 2006

TBC

STA

colon cancer (adjuvant)—irinotecan (Campto)

16 June 2004 (transferred to STA programme August 2006)

Suspended: Campto is not currently licensed in the United Kingdom for this indication.

TBC

STA

non-Hodgkin's lymphoma—rituximab (MabThera)

Review of TA37 5 April 2005

December 2007

STA

glioblastoma multiforme (recurrent)—carmustine implants (Gliadel)

21 June 2004 (transferred to STA programme August 2006)

January 2008

STA

head and neck cancer—cetuximab (Erbitux)

21 June 2004

Three appeals have been made against the Final Appraisal Determination.

To be confirmed—subject to outcome of appeals.

STA

lung cancer (non small cell)—bevacizumab (Avastin)

19 December 2006

January 2008

STA

lung cancer (non small cell)—erlotinib (Tarceva)

5 April 2005 (transferred to STA programme November 2005)

NICE awaits the decision of the appeal hearing heard on 6 June 2007.

To be confirmed—subject to outcome of appeals.

STA

lung cancer (non small cell)—pemetrexed (Alimta)

5 April 2005 (transferred to STA programme November 2005)

NICE awaits the decision of the appeal hearing heard on 6 June 2007.

To be confirmed—subject to outcome of appeals.

MTA

lung cancer (non small cell)—gefitinib (Iressa)

1 April 2003

Suspended: Iressa is not currently licensed in the UK for this indication.

To be confirmed

MTA

mesothelioma—pemetrexed disodium

21 June 2004

September 2007

STA

relapsed multiple myeloma—bortezomib (Velcade)

21 July 2005 (transferred to STA programme November 2005)

To be confirmed

STA

pancreatic cancer—Rubetican

21 June 2004 (transferred to STA programme November 2005)

Suspended: The manufacturers have withdrawn their licence application.

To be confirmed

STA

prostate cancer (hormone refractory)—Atrasentan

21 June 2004 (transferred to STA programme November 2005)

Suspended: Atrasentan is not currently licensed in the UK for this indication.

To be confirmed

STA

breast cancer—bevacizumab (Avastin)

19 June 2007

To be confirmed

MTA

renal cell carcinoma—bevacizumab (Avastin), sorafenib tosylate (Nexavar) and sunitinib (Sutent)

19 June 2007

To be confirmed