Today (Tuesday 24 May), the National Institute for Health and Clinical Excellence (NICE) has issued new draft guidance which recommends a treatment that can help delay the growth and spread of follicular non-Hodgkin's lymphoma. The draft guidance states that rituximab can be used as a first-line maintenance treatment1 in people with follicular non-Hodgkin's lymphoma that has responded to first-line induction therapy2 with rituximab in combination with chemotherapy.
Standard clinical practice for these patients, around 1600 in the UK3, is for doctors to wait for the cancer to grow again following successful induction therapy, before giving them further treatment. However the evidence presented to NICE's independent committee by the manufacturer, and advice from clinical specialists suggest that treating patients with rituximab maintenance after induction therapy can prevent the spread and growth of this cancer by 3-4 years4.
The manufacturer's economic modelling also convinced the committee that first-line rituximab maintenance treatment for these patients could be a cost-effective use of NHS resources compared with current clinical practice.
Professor Peter Littlejohns, Clinical and Public Health Director at NICE, said: “We are pleased to be able to provisionally recommend rituximab maintenance therapy as an option for the treatment of people with follicular non-Hodgkin's lymphoma that has responded to first-line induction therapy with rituximab in combination with chemotherapy.
“Using rituximab as a maintenance treatment after initial chemotherapy for follicular non-Hodgkin's lymphoma could be a valuable treatment option for hundreds of patients because no such maintenance treatment has so far been available at this stage of the disease. The evidence presented to the committee highlighted that it could keep a patient's cancer in remission for longer, after they have had chemotherapy.
“Alongside its proven clinical effectiveness, the Appraisal Committee has also established that rituximab first-line maintenance offers value for money for the NHS.”
In line with the NICE technology appraisals process this draft guidance is now with consultees, who have the opportunity to appeal against the proposed guidance NICE has not yet published final guidance for the NHS.
1 A maintenance treatment is used to stop a cancer from returning following initial chemotherapy
2 Induction therapy is a type of treatment that is first given to a patient to reduce the size of the cancer or stop the cancer from progressing.
3 Roche Budget Impact Model, 2009 (Manufacturer's submission)
4 That is, 1 to 2 years sustained benefit after treatment has stopped.