Draft guidelines from the National Institute for Health and Care Excellence for the treatment of recurrent ovarian cancer recommend two therapies for National Health Service use but reject a further three.

The Institute says paclitaxel and pegylated liposomal doxorubicin hydrochloride (Jansen-Cilag’s Caelyx) should be considered options for treating the disease if it returns after chemotherapy, with both recommended either as monotherapies or in combination with platinum. 

However, the cost watchdog rejected gemcitabine, topotecan and trabectedin (PharmaMar’s Yondelis) to treat the first recurrence of platinum-sensitive ovarian cancer, while topotecan was also provisionally turned down for treating cancer that has returned within six months of treatment with a platinum-based regimen or cancer which did not respond to platinum treatment at all. 

“NICE makes difficult decisions to ensure that people using the NHS get access to the most cost-effective treatments, and to help the NHS to share its resources fairly,” said Meindert Boysen, the Institute’s Programme Director of Appraisals.

The independent committee found the evidence on gemcitabine, topotecan and trabectedin “indicated that they didn’t provide enough extra health benefit for the cost to the NHS”.