NICE does not recommend imatinib at a dose of 600 or 800 mg a day for people with unresectable and/or metastatic GISTs whose disease has got worse after treatment with imatinib at a dose of 400 mg a day.

This guidance updates Imatinib for the treatment of unresectable and/or metastatic gastrointestinal stromal tumours (NICE technology appraisal guidance 86).

Recommendation 1.5 in TA86 has been replaced. All the other recommendations in TA86 still apply. Please see the guidance for more information.

Why has NICE said this?

NICE looks at how well treatments work, and also at how well they work in relation to how much they cost the NHS. NICE applies special considerations to treatments that can extend the lives of people who are nearing the end of their life. There is not enough evidence from clinical trials to say how well an increased dose of imatinib works, or whether it works well enough to justify its cost, so NICE did not recommend it.

Your responsibility

The recommendations in this guidance represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, health professionals are expected to take this guidance fully into account, alongside the individual needs, preferences and values of their patients. The application of the recommendations in this guidance is at the discretion of health professionals and their individual patients and do not override the responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or their carer or guardian.

Commissioners and/or providers have a responsibility to provide the funding required to enable the guidance to be applied when individual health professionals and their patients wish to use it, in accordance with the NHS Constitution. They should do so in light of their duties to have due regard to the need to eliminate unlawful discrimination, to advance equality of opportunity and to reduce health inequalities.

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