NICE backs funding for AZ's Lynparza ovarian cancer maintenance therapy

NICE has recommended interim funding on England’s NHS for AstraZeneca’s ovarian cancer drug Lynparza in the earlier stages of the disease as a maintenance treatment after an initial round of chemotherapy.

The cost-effectiveness body in final draft guidance said the Cancer Drugs Fund should reimburse Lynparza (olaparib) in adults with advanced high-grade epithelial ovarian, fallopian tube, or peritoneal cancer that has responded to first-line platinum-based chemotherapy.

NICE said the twice-daily tablet will be funded as long as the conditions of a managed access agreement between AstraZeneca and NHS England are followed.

As is usually the case, AstraZeneca has offered the drug at a discounted price to secure the funding from NICE.

There were uncertainties in the evidence AZ has presented so far that NICE has been unable to resolve and the cost-effectiveness body is awaiting further data from the ongoing SOLO-1 trial to confirm the drug’s survival benefit.

The estimate is that Lynparza delays disease progression by around three years compared with placebo, but overall survival data is not currently available because those on the trial have not been followed up for long enough.

Around 700 patients a year are expected to benefit from this decision.

Meindert Boysen, director of the NICE Centre for Health Technology Evaluation, said: “The availability of olaparib tablets as maintenance therapy is an important development in the management of BRCA mutation-positive advanced ovarian cancer.

“Olaparib is already used for ovarian cancer but is expected to have the greatest benefit when used early, and is considered to have the potential to cure the disease in some people if given before the first recurrence.

“We are pleased that the company has agreed a commercial arrangement for olaparib that will allow it to be made available immediately to people who currently have an unmet need for maintenance treatment.”

Lynparza is a poly (ADP-ribose) polymerase (PARP) inhibitor that works by preventing this protein in cancer cells from repairing damaged DNA in patients with BRCA mutations.

This causes cancer cells to die but does not affect healthy cells, which are not reliant on the PARP protein to survive.

Lynparza will be available in this earlier use immediately and subject to appeal NICE’s final guidance will be published next month.

NICE in 2016 recommended Lynparza in the later stages of ovarian cancer, if they had three or more courses of platinum chemotherapy.