Use of ovarian cancer drug which could help thousands is ruled against

Cancer specialists slam ‘disappointing’ decision by health watchdog to NOT recommend a drug for women battling advanced ovarian cancer

  • Nice has ruled against expanding the use of a groundbreaking drug Olaparib
  • It’s used by women with inherited mutations to the BRCA breast cancer gene
  • Charity cancers call it a ‘bitter blow’ to thousands who could miss out

Cancer specialists have today slammed the ‘disappointing’ decision by the health watchdog to not recommend an ovarian cancer drug. 

The National Institute for Health and Care Excellence (Nice) has said olaparib was not considered to be cost effective. 

The ‘pioneering’ drug is available on the NHS for women with ovarian cancer who have inherited mutations to the BRCA genes.

Studies have shown a larger amount of women could also benefit from the drug. But Nice says it would not expand its use in draft guidelines. 

In 2016, 6,430 people were diagnosed with ovarian cancer in England and more than 4,000 women die from it every year in the UK.

Health leaders have decided not to recommend a drug, called olaparib (pictured), that could help thousands of woman battling advanced ovarian cancer

The UK has the worst five-year survival rate for ovarian cancer in Europe, with six out of 10 cases in England diagnosed at an advanced stage.

Between 5-15 per cent of ovarian cancers are caused by faulty genes, called BRCA, which can be identified through genetic testing. 

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Nice said clinical trial results showed that olaparib, which is also called Lynparza, extends the time until the cancer gets worse compared with placebo (around 8.4 months with olaparib and 4.8 months with placebo).

It said this benefit is greater in the BRCA mutation-positive subgroup, for which Nice has already recommended olaparib as a third-line treatment.

How Olaparib works

Olaprabic, or Lynparza, was developed by researchers based at the Francis Crick Institute in London and Oxford University.  

The scientists discovered a weakness in cancer ‘s defence. 

Cancer grows when a fault in normal DNA stops it from repairing itself.

But even tumour cells need DNA repair mechanisms to survive, so they use a ‘back-up’ repair process – a protein called Pol-theta – that healthy cells do not usually need.

This reliance on Pol-theta leaves cancer vulnerable to attack because if scientists can block its one survival route the cancer cannot recover after being blasted with radiation. 

Olaprabic, takes as a capsule, blocks the ability of tumour cells to repair themselves. 

They hope this will mean a lower dose of radiation can be used, sparing healthy tissue while having a greater effect on the cancer.

It is the first of a group of drugs called PARP inhibitors.  

Like any drug, it has side effects, including headaches, nausea, skin reactions and dizziness.

The drug has now been approved for women with ovarian cancer and inherited mutations to the BRCA breast cancer genes, and clinical trials are continuing in other groups of patients.

Olaparib, made by British universities, was found to extend the lives of severely ill women with this type of ovarian cancer in a 2013 study.

Two thirds of the patients given the drug had not relapsed within three years, compared to a third among those who were given a placebo.

The results were described as ‘exciting’ by doctors.

But due to the £4,635 cost for the ground-breaking tablets per 28-day cycle, Nice does not recommend it as a maintenance treatment for adults with relapsed, platinum-sensitive ovarian, fallopian tube and peritoneal cancer.   

Professor Paul Workman, chief executive of the Institute of Cancer Research (ICR), London, said the decision was a ‘disappointing one for women with advanced ovarian cancer and their doctors’.  

‘Use of olaparib in women without BRCA mutations would be more clearly cost-effective if we could learn more about which women benefit and had a better test to pick them out for treatment’, Prof Workman added.

‘We would like to see olaparib available on the NHS for a broader group of women, to provide them with an important new treatment option.’  

Alex Holden, from the charity Target Ovarian Cancer, said: ‘Any reduction in treatments is a disappointment and a bitter blow to women with ovarian cancer in the UK.

‘This is a disease that needs more treatments, not fewer, and more investment in ovarian cancer research is desperately needed to find the treatments of tomorrow.’  

Some 27 per cent of all cancer patients receive radiotherapy, with more than 130,000 people in England undergoing the treatment every year.

The treatment is very effective but can involve long-term side effects because healthy tissue is also irradiated. 

Olaparib reduces this impact by ‘sensitizing’ tumour cells to radiotherapy, and reduces the amount of radiotherapy needed.

The draft guidance is open for public consultation until November 30 and final guidance is expected to be published in April 2019.

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