1.1 Niraparib is recommended as an option for treating relapsed, platinum-sensitive high-grade serous epithelial ovarian, fallopian tube or primary peritoneal cancer that has responded to the most recent course of platinum-based chemotherapy in adults. It is recommended only if:
they have a BRCA mutation and have had 2 courses of platinum-based chemotherapy, or
they do not have a BRCA mutation and have had 2 or more courses of platinum-based chemotherapy, and
the company provides it according to the commercial arrangement.
Why the committee made these recommendations
This appraisal reviews the additional evidence collected as part of the Cancer Drugs Fund managed access agreement for niraparib for maintenance treatment of relapsed, platinum-sensitive ovarian, fallopian tube and peritoneal cancer (NICE technology appraisal guidance 528).
Niraparib improves how long people with relapsed, platinum-sensitive ovarian, fallopian tube and peritoneal cancer live before their disease progresses. New evidence collected while niraparib was available through the Cancer Drugs Fund suggests it may also extend how long these people live. But, it is uncertain if niraparib extends how long people without a BRCA mutation may live.
Cost-effectiveness estimates for niraparib in people with a BRCA mutation whose disease has responded to 2 courses of platinum-based chemotherapy and for people without a BRCA mutation whose disease has responded to 2 or more courses of platinum-based chemotherapy are in the range usually considered a cost-effective use of NHS resources. Therefore, niraparib is recommended.