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The National Institute for Health and Clinical Excellence (NICE) is currently appraising the use of pemetrexed for the maintenance treatment of non-small-cell lung cancer. In its draft guidance, published today (17 December 2009), NICE does not recommend pemetrexed. However, this draft guidance has been issued for consultation and the manufacturer now has an opportunity to consider and respond to comments made by the independent Appraisal Committee

Lung cancer is one of the most common cancers in the UK, with around 38,000 people diagnosed every year.  Maintenance treatment after first-line treatment is a new concept in lung cancer care and is not currently practised in the UK.

The goals of maintenance treatment are to prolong the period of remission after first-line chemotherapy and increase the likelihood of being able to receive second-line chemotherapy

Dr Carole Longson, Health Technology Evaluation Centre Director at NICE said: “In September NICE recommended pemetrexed as a first line treatment for non-small-cell lung cancer and we are disappointed not to have been able to recommend the drug as a maintenance treatment as well. The committee felt that there were many uncertainties in the data and analysis provided by the manufacturer. These uncertainties led the committee to conclude that, on current evidence, the cost of the drug related to the benefits it brings means that pemetrexed would not be a good use of NHS money.

“The next step in the NICE process is for the manufacturer to consider the Committee’s comments and respond to its concerns.”

NICE’s preliminary recommendations are available for public consultation from 17 December 2009 until 19 January 2010. Comments received during this consultation will be considered by the Committee and following this meeting the next draft guidance will be issued. Until NICE issues final guidance, NHS bodies should make decisions locally on the funding of specific treatments.