NICE has developed a medtech innovation briefing (MIB) on TheraSphere for treating operable and inoperable hepatocellular carcinoma.
TheraSphere is a selective internal radiation therapy consisting of glass microspheres containing radioactive yttrium 90. It is designed to be used to treat patients with primary hepatocellular carcinoma with or without portal vein thrombosis. TheraSphere can also be used to downstage tumours for resection or liver transplantation, or as a bridge to transplantation. TheraSphere delivers radiation directly to tumours through the hepatic artery, which limits damage to normal liver cells. The evidence from 11 studies summarised in this briefing is of mixed quality and shows that patients treated with TheraSphere do not show significantly different overall survival times compared with those treated with conventional transarterial chemoembolisation (TACE) with lipiodol. Disease control, time to progression and quality of life were similar or improved in patients treated with TheraSphere compared with conventional TACE. One study showed that drug-eluting bead TACE (DEB-TACE) using doxorubicin extended survival when compared with TheraSphere. Two studies reported that patients treated with TheraSphere experienced fewer or similar numbers of adverse events compared with conventional TACE. Four studies reported that patients treated with TheraSphere spent fewer days in hospital compared with those treated with conventional TACE. The list price of TheraSphere is £8,000 excluding VAT. The total price used to reimburse NHS centres is about £21,550, which covers the total cost of TheraSphere treatment.
NICE has produced a Medtech innovation briefing on another selective internal radiation therapy technology, SIR-Spheres.
MIBs provide a description of the medical technology, including its likely place in therapy, the costs of using the technology and a critical review of the strengths and weaknesses of the relevant published evidence.
Their purpose is to provide objective information on device and diagnostic technologies to aid local decision-making by clinicians, managers and procurement professionals. By making this information available, NICE helps to avoid the need for NHS organisations to produce similar information for local use.
MIBs are not NICE guidance. They differ in format, contain no judgement on the value of the technology and do not constitute a guidance recommendation.
MIBs are commissioned by NHS England and produced in support of the NHS 5 Year Forward View, specifically as one of a number of steps which will accelerate innovation in new treatments and diagnostics.