TOPOTECAN FOR CERVICAL CANCER

Topotecan for the treatment of recurrent and stage IVB carcinoma of the cervix: an assessment based on the manufacturer’s submission to NICE

Background

The aim of this NICE STA was to appraise the clinical and cost-effectiveness of topotecan within its licensed indication for the treatment of recurrent and stage IVB carcinoma of the cervix. CRD researchers together with researchers from the Centre for Health Economics (CHE) comprised the Evidence Review Group for this STA. The work involved a detailed assessment of the manufacturer’s submission to NICE on the clinical and cost-effectiveness of topotecan.

Findings

The existing research in this area is limited. Further trials are required to establish the efficacy of topotecan plus cisplatin relative to other treatments that are used in UK clinical practice, for example, carboplatin single or combination therapy.

The manufacturer's submission included a non-standard economic analysis consisting of two parts. The primary economic evaluation was an individual patient level data cost-utility analysis of topotecan in combination with cisplatin versus cisplatin monotherapy. In addition, a secondary modelled analysis using indirect evidence was undertaken to compare topotecan plus cisplatin versus paclitaxel plus cisplatin. The cost-effectiveness results were subject to a number of potential sources of uncertainty. Further research could be undertaken in order to obtain more robust estimates of the potential cost-effectiveness of topotecan plus cisplatin.

Conducted by: F Paton1, M Paulden2, P Saramago2, A Manca2, K Misso1, S Palmer2, A Eastwood1

1. Centre for Reviews and Dissemination; 2. Centre for Health Economics, University of York

Further details

Project page on the NIHR HTA Programme website

Related guidance

Commissioned to inform NICE Technology Appraisal Guidance: Topotecan for the treatment of recurrent carcinoma of the cervix. London: National Institute for Clinical Excellence; 2009

Publications

CRD and CHE Technology Assessment Group. Topotecan for the treatment of recurrent and stage IVB carcinoma of the cervix: a Single Technology Appraisal. Centre for Reviews and Dissemination / Centre for Health Economics, 2009

Paton F, Paulden M, Saramago P, Manca A, Misso K, Palmer S, Eastwood A. Topotecan for the treatment of recurrent and stage IVB carcinoma of the cervix. Health Technol Assess. 2010; 14:Suppl 1: 55-62

Funding

Commissioned by the NIHR HTA Programme in support of NICE's Single Technology Appraisal process.

NICE’s single technology appraisal (STA) process is specifically designed for the appraisal of a single product, device or other technology, with a single indication. The STA process normally covers new technologies and is designed to provide recommendations in the form of NICE guidance soon after the technology is introduced into the UK market. The principal evidence in the STA process is submitted by the manufacturer or sponsor of the technology.