fizer’s Sutent has received backing once again from the National Health Service cost watchdog for England and Wales, after its use was recommended for patients with rare gastrointestinal tumours hot on the heels of a green light in kidney cancer.

The National Institute for Health and Clinical Excellence has published a Final Appraisal Determination endorsing the use of Sutent (sunitinib) for patients with advanced gastrointestinal stromal tumour (GIST), on the basis that the treatment is a cost-effective use of NHS resources.

Specifically, Sutent is recommended for reimbursement as a treatment option in patients with advanced GIST when their disease progresses despite therapy with Novartis’ Glivec/Gleevec (imatinib mesylate), or for those who are intolerant to it.

NICE’s decision was based on findings of a Phase III clinical trial showing that Sutent increased time to tumour progression by almost five months compared to placebo. “The benefits seen in time to tumour progression and progression free survival were such that a substantial improvement in overall survival with sunitinib treatment was probable,” the Institute explained.

“NICE’s decision gives hope to patients with GIST who develop resistance to imatinib,” said Dr Mace Rothenberg, senior vice president of clinical development and medical affairs at Pfizer’s Oncology Business Unit, and he added: “Insights into the causative pathways involved with cancers like GIST will help us bring Sutent to the right patient at the right time”.

OK for complementary therapies in back pain
Meantime, the Institute has, for the first time, endorsed the use of certain complementary therapies on the National Health Service for patients with back pain.

In its new guidelines for the management of non-specific, low back pain, which affects around one in three adults in the UK every year, the Institute has endorsed massage and a course of acupuncture up to a maximum of 10 sessions over a period of up to 12 weeks alongside normal strategies such as exercise and drug injections.

“This guideline heralds a sea-change in the treatment of low back pain,” commented Professor Martin Underwood, Chair of the Guideline Development Group and GP. “I am delighted that now, as a GP, I’ll be able to offer my patients a choice of therapies for persistent low back pain that have been shown to work”.

There is currently significant variation in clinical practice for back pain around the country, and it is hoped that the new guidelines will help to foster a consistent clinical approach to the management of the condition.