The UK’s National Institute for Health and Clinical Excellence has extended the use of two colon cancer drugs – Pfizer’s Campto (irinotecan) and Sanofi-Aventis’ Eloxatin (oxaliplatin) in combination with 5-fluorouracil and folinic acid – to include all patients who have not received any prior therapy, significantly broadening their market potential. However, it was not such good news for AstraZeneca’s Tomudex (raltitrexed), which remains not recommended and its use limited to studies.

The move marks a dramatic turnaround for NICE, which had previously restricted Eloxatin’s use to colorectal cancer patients whose disease had only spread to the liver and might be operable after treatment, saying that routine first line treatment was not cost-effective. Campto was recommended as a second line monotherapy where 5FU treatments had failed or were inappropriate [[08/03/02e]].

This use has not only been extended to first-line therapy but to all stages of the disease, and has been particularly well received amongst colorectal oncologists who petitioned for an early review of the guidance, believing the original 2002 NICE recommendations potentially denied patients the survival benefits associated with these drugs. Commenting on the new guidance, Professor David Cunningham, Consultant Oncologist from the Royal Marsden, London said: “We are delighted with the recommendations made within the NICE guidance. The wider use of these modern treatments will undoubtedly lead to better treatment and therefore, improved outcomes for our patients. However, it is crucial that patients gain access to these drugs at the earliest opportunity to ensure optimal results.”

Colorectal cancer is the second most-common tumour after lung cancer in England and Wales, the two countries covered by NICE guidance. Every year, around 30,000 new cases of colorectal cancer are diagnosed, and around 30% of these will present with advanced disease.