WIREDGOV

In final guidance published today, NICE is pleased to be able to recommend two new treatments; for inoperable advanced gastric cancer and for non small cell lung cancer.

Capecitabine (Xeloda, Roche Products) is recommended, in combination with a platinum-based regimen, for the first-line treatment of inoperable advanced gastric cancer and gefitinib (Iressa) is recommended for the first-line treatment of people with locally advanced or metastatic non-small-cell lung cancer if they test positive for the epidermal growth factor receptor tyrosine kinase (EGFR-TK) mutation.

Dr Carole Longson, Health Technology Evaluation Centre Director at NICE said: "NICE has already recommended a number of treatments for non small lung cancer. Gefitinib has now been added to this list of treatment options, with the advantage that it is taken in tablet form, meaning it can be taken at home, and would allow patients to carry on with normal daily activities

"Before today patients with inoperable advanced gastric cancer were generally treated with fluorouracil via an infusion pump. However, capecitabine-based regimens work as well as intravenous fluorouracil and because the treatment is with tablets, rather than an infusion pump, patients will spend less time in hospital.

"Non small cell lung cancer and gastric cancer can both be devastating conditions, with gastric cancer affecting approximately 8,200 people in the UK every year and non small cell lung cancer approximately 38,000. We are very pleased to be able to recommend both capecitabine and gefitinib for use on the NHS today."

Notes to Editors

About the appraisals

• When a NICE technology appraisal recommends use of a drug or treatment, or other technology, the NHS must provide funding and resources for it within 3 months of the guidance being published. The NHS is not required to fund treatments that are not recommended by NICE.

Capecitabine

• View the capecitabine guidance for further information.
• Although slightly more expensive to buy than fluorouracil, capecitabine is cheaper to give (as it is oral rather than given via an infusion pump). Therefore capecitabine is cost saving compared with fluorouracil

Gefitinib

• View the gefitinib guidance for further information.
• The manufacturer proposed a patient access scheme where the drug is provided at no cost for patients who are treated for up to two months and, for all other patients’, gefitinib would be available at a single fixed cost irrespective of the duration of treatment.
• Gefitinib showed longer progression-free survival and similar effects in terms of overall survival compared with the current treatment of pemetrexed used in combination with cisplatin.
• Smoking cigarettes, pipes, or cigars is the most common cause of lung cancer. Other risk factors include:

1. Smoking cigarettes in the past.
2. Being exposed to second-hand smoke.
3. Being treated with radiation therapy to the breast or chest.
4. Being exposed to asbestos, radon, chromium, nickel, arsenic, soot, or tar.
5. Living where there is air pollution.

When smoking is combined with other risk factors, the risk of developing lung cancer is increased.

About NICE

• The National Institute for Health and Clinical Excellence (NICE) is the independent organisation responsible for providing national guidance on the promotion of good health and the prevention and treatment of ill health.
• NICE produces guidance in three areas of health:

public health - guidance on the promotion of good health and the prevention of ill health for those working in the NHS, local authorities and the wider public and voluntary sector

health technologies - guidance on the use of new and existing medicines, treatments and procedures within the NHS

clinical practice - guidance on the appropriate treatment and care of people with specific diseases and conditions within the NHS.