Authors' objectives:

To provide guidance on the use of paclitaxel, pegylated liposomal doxorubicin hydrochloride and topotecan for second-line or subsequent treatment of advanced ovarian cancer. This guidance will replace the following guidance issued by the Institute: - Ovarian cancer topotecan; Technology Appraisal Guidance no. 28 (2001) - Ovarian cancer (advanced) pegylated liposomal doxorubicin hydrochloride; Technology Appraisal Guidance no. 45 (2002)

This guidance replaces recommendations 1.3, 1.4 and 1.5 on the second-line treatment of advanced ovarian cancer in the following guidance. - Ovarian cancer paclitaxel (review); Technology Appraisal Guidance no. 55 (2003)

The recommendations for first-line therapy in Technology Appraisal Guidance no. 55 are not affected by this guidance.

Authors' recommendations: Guidance: This guidance applies only to paclitaxel, pegylated liposomal doxorubicin hydrochloride (PLDH) and topotecan. For the purposes of this guidance, the following definitions are used: - platinum-sensitive ovarian cancer: disease that responds to first-line platinum-based therapy but relapses 12 months or more after completion of initial platinum-based chemotherapy - partially platinum-sensitive ovarian cancer: disease that responds to first-line platinum-based therapy but relapses between 6 and 12 months after completion of initial platinum-based chemotherapy - platinum-resistant ovarian cancer: disease that relapses within 6 months of completion of initial platinum-based chemotherapy - platinum-refractory ovarian cancer: disease that does not respond to initial platinum-based chemotherapy. 1.1 Paclitaxel in combination with a platinum-based compound (carboplatin or cisplatin) is recommended as an option for the second-line (or subsequent) treatment of women with platinum-sensitive or partially platinum-sensitive advanced ovarian cancer, except in women who are allergic to platinum-based compounds. 1.2 Single-agent paclitaxel is recommended as an option for the second-line (or subsequent) treatment of women with platinum-refractory or platinum-resistant advanced ovarian cancer, and for women who are allergic to platinum-based compounds. 1.3 PLDH is recommended as an option for the second-line (or subsequent) treatment of women with partially platinum-sensitive, platinum-resistant or platinum-refractory advanced ovarian cancer, and for women who are allergic to platinum-based compounds. 1.4 Topotecan is recommended as an option for second-line (or subsequent) treatment only for those women with platinum-refractory or platinum-resistant advanced ovarian cancer, or those who are allergic to platinum-based compounds, for whom PLDH and single-agent paclitaxel are considered inappropriate. 1.5 Within these recommendations, the choice of treatment for second-line (or subsequent) chemotherapy should be made after discussion between the responsible clinician and the patient about the risks and benefits of the options.

Authors' methods: Systematic review

Project Status: Completed

URL for project: http://www.nice.org.uk/page.aspx?o=258937

Year Published: 2005

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: England, United Kingdom

Organisation Name: National Institute for Clinical Excellence

Contact Address: MidCity Place, 71 High Holborn, London WC1V 6NA, UK. Tel: +44 020 7067 5800; Fax: +44 020 7067 5801

Contact Name: nice@nice.nhs.uk

Contact Email: nice@nice.nhs.uk

Copyright: National Institute for Clinical Excellence (NICE)