1 Recommendations
1.1 Paclitaxel in combination with platinum or as monotherapy is recommended within its marketing authorisation as an option for treating recurrent ovarian cancer.
1.2 Pegylated liposomal doxorubicin hydrochloride (PLDH) as monotherapy is recommended within its marketing authorisation as an option for treating recurrent ovarian cancer.
1.3 PLDH in combination with platinum is recommended as an option for treating recurrent ovarian cancer.[1][2]
1.4 The following are not recommended within their marketing authorisations for treating the first recurrence of platinum‑sensitive ovarian cancer:
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gemcitabine in combination with carboplatin
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trabectedin in combination with PLDH
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topotecan.
The appraisal committee was unable to make recommendations on the use of these technologies for treating platinum‑sensitive ovarian cancer beyond the first recurrence.
1.5 Topotecan is not recommended within its marketing authorisation for treating recurrent platinum‑resistant or platinum‑refractory ovarian cancer.
1.6 People whose treatment with gemcitabine in combination with carboplatin, trabectedin in combination with PLDH, or topotecan is not recommended in this NICE guidance, but was started within the NHS before this guidance was published, should be able to continue treatment until they and their NHS clinician consider it appropriate to stop.
[1] At the time of publication (April 2016), PLDH (Caelyx) in combination with platinum did not have a UK marketing authorisation for this indication. The prescriber should follow relevant professional guidance, taking full responsibility for the decision. Informed consent should be obtained and documented. See the General Medical Council's Good practice in prescribing medicines – guidance for doctors for further information.
[2] The use of PLDH (Caelyx) in combination with platinum is outside the terms of the marketing authorisation for Caelyx. Consequently the statutory funding requirement does not apply to this recommendation. NICE received a remit to appraise this combination under Regulation 5 of the National Institute for Health and Care Excellence (Constitution and Functions) and the Health and Social Care Information Centre (Functions) Regulations 2013.