1.1 Olaparib plus bevacizumab is recommended for use within the Cancer Drugs Fund as an option for maintenance treatment of advanced (International Federation of Gynecology and Obstetrics [FIGO] stages 3 and 4) high-grade epithelial ovarian, fallopian tube or primary peritoneal cancer in adults when:
the cancer is associated with homologous recombination deficiency (HRD).
It is recommended only if the conditions in the managed access agreement for olaparib are followed.
1.2 This recommendation is not intended to affect treatment with olaparib plus bevacizumab that was started in the NHS before this guidance was published. People having treatment outside this recommendation may continue without change to the funding arrangements in place for them before this guidance was published, until they and their NHS clinician consider it appropriate to stop.
Why the committee made these recommendations
There is an ongoing clinical trial comparing maintenance treatment with olaparib plus bevacizumab with placebo plus bevacizumab in people whose cancer has responded to first-line platinum-based chemotherapy plus bevacizumab. Early results suggest that it improves how long people live without their cancer getting worse. The evidence suggests that the treatment effect is bigger in people whose disease is HRD-positive. However, there is uncertainty about how olaparib plus bevacizumab affects the length of time people live.
The uncertainty in the clinical evidence means that the cost-effectiveness estimates are very uncertain, so the treatment is not recommended for routine use in the NHS.
If the treatment does increase the length of time people live, it has the potential to be cost effective. Further trial results will help to address the uncertainties in the clinical-and cost-effectiveness estimates. Therefore, olaparib plus bevacizumab maintenance treatment is recommended for use within the Cancer Drugs Fund while further data are collected.