NICE has made the following recommendations about the use of rituximab (Mab Thera) to treat aggressive non-Hodgkin’s lymphoma.
NICE has recommended that rituximab and the CHOP combination of chemotherapy medicines (a combination of cyclophosphamide, doxorubicin, vincristine and prednisolone) should be the first treatment considered for people with diffuse large-B-cell lymphoma that is at stage 2, 3 or 4. (These people should have CD20 on their B cells – see full guidance document.)
Rituximab is not recommended for people who are unable to have chemotherapy with the CHOP combination.
NICE has said that rituximab should only be used in people with diffuse large-B-cell lymphoma in stage 1 if they are being treated as part of a clinical study. This is because, at present, there isn’t enough evidence that rituximab works well or that it works well enough considering its cost in this group of people for it to be used routinely.
The last recommendation from NICE is that treatment with rituximab and CHOP should be supervised by a doctor who has specialised in the treatment of lymphomas.
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.