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NICE publishes draft guidance on ovarian cancer drug

Draft guidance on the use of bevacizumab as a treatment for women with advanced ovarian cancer has been published by the National Institute for Health and Clinical Excellence (NICE).

NICE does not recommend that the drug - marketed by Roche under the trade name Avastin - is a cost-effective treatment on the NHS when used with paclitaxel and carboplatin in patients with advanced disease.

In UK clinical practice bevacizumab is prescribed at a dosage below that for which it is currently licensed, NICE’s independent Advisory Committee acknowledged, but it said that NICE is unable to make recommendations on its use outside its marketing authorisation.

The manufacturer submitted evidence from clinical trials that related both to its use as per its licensed dosage and its commonly used but unlicensed dosage, making it difficult to ascertain its clinical effectiveness.

Clinical trial GOG-0218, which assessed the drug’s licensed dose, was deemed by the committee to be the most relevant although it did raise questions about the consistency of how the results within that study were recorded and whether the “censored” or “uncensored” data was most appropriate to assess.

NICE chief executive Sir Andrew Dillon said: “Although it was acknowledged that bevacizumab, when used in combination with paclitaxel and carboplatin, did appear to provide some benefit to some patients in terms of delaying the spread of their cancer, it was unclear whether this translated into an overall survival benefit.”

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