Topotecan, pegylated liposomal doxorubicin hydrochloride and paclitaxel for the treatment of advanced ovarian cancer (review of TA28, TA45 and TA55 (for relapsed disease only))

The guidance issued by NICE only applies to paclitaxel, PLDH and topotecan. NICE has issued the following recommendations for the treatment of women with advanced ovarian cancer.

For women for whom the cancer is:

• platinum-sensitive or partially platinum-sensitive, except women who are allergic to platinum-based drugs, paclitaxel in combination with a platinum-based drug (carboplatin or cisplatin) as an option for second-line (or subsequent) treatment should be considered.
• partially platinum-sensitive, platinum-resistant or platinum-refractory, and women who are allergic to platinum-based compounds, PLDH as an option for second-line (or subsequent) treatment should be considered.
• platinum-refractory or platinum-resistant, and women who are allergic to platinum-based compounds, paclitaxel on its own as an option for second-line (or subsequent) treatment should be considered.
• .platinum-refractory or platinum-resistant, or women who are allergic to platinum-based compounds, for whom PLDH and single-agent paclitaxel are considered inappropriate, topotecan as an option for second-line (or subsequent) treatment should be considered.

These recommendations also apply to ovarian cancer that relapses after second-line chemotherapy; this is called ‘subsequent’ chemotherapy.

Specialists should discuss the risks and benefits of each treatment option with patients before deciding which treatment to use for second-line (or subsequent) chemotherapy in line with the recommendations.

This guidance replaces TA28 Ovarian cancer - topotecan and TA45 Ovarian cancer (advanced) - pegylated liposomal doxorubicin hydrochloride.

This guidance replaces recommendations 1.3, 1.4 and 1.5 on re-challenge therapy and the second-line treatment of advanced ovarian cancer in ‘Guidance on the use of paclitaxel in the treatment of ovarian cancer (review)’ (NICE technology appraisal guidance 55). The recommendations for first-line treatment in TA55 are not affected by this guidance.

• Other information

  • TA91 Ovarian cancer (advanced) - paclitaxel, pegylated liposomal doxorubicin hydrochloride and topotecan (review): guidance (web format)

  How this guidance was produced

  Background information

  • Review decision - August 2010
  • TA91 Ovarian cancer (advanced) - paclitaxel, pegylated liposomal doxorubicin hydrochloride and topotecan (review): Review Decision - May 2008
  • Review Proposal - March 2008
  • Review Proposal - March 2008: Provisional matrix of consultees and commentators
  • Assessment report: Ovarian cancer (advanced)
  • TA91 Ovarian cancer (advanced) - paclitaxel, pegylated liposomal doxorubicin hydrochloride and topotecan (review): Distribution list
  • Review proposal February 2010: proposal to defer the review

Guidance formats

• Web format
• Quick reference guide (PDF)
• Full Guidance (PDF)
• Patient version (PDF)

Ovarian cancer (advanced) - paclitaxel, pegylated liposomal doxorubicin hydrochloride and topotecan (review)

Guideline for patients and carers (PDF)