The National Institute for Health and Clinical Excellence (NICE) has issued a new draft version of its guidance on the clinical and costeffectiveness of carmustine implants and temozolomide for the treatment of newly diagnosed high-grade glioma, with final guidance expected in June 2007.
The draft recommendations are as follows:
Temozolomide, within its licensed indications, is recommended for the treatment of newly diagnosed glioma in patients with a World Health Organization (WHO) performance status of 0 or 1.
Carmustine implants are not recommended for the treatment of newly diagnosed highgrade glioma.
Andrea Sutcliffe, Deputy Chief Executive at NICE and Executive Lead for this appraisal, said: “Our review of the evidence indicates that carmustine implants have a small benefit in overall survival in newly diagnosed high-grade glioma, but there was insufficient evidence to demonstrate its benefit as a cost-effective use of NHS resources.
“Our review of the evidence on temozolomide demonstrated a small improvement in overall survival for all patients with high grade glioma. However, the survival benefits were greatest for those patients who are able to carry out normal activities without restriction and patients who are restricted in strenuous activity but are able to walk and carry out light work – defined as a WHO status of 0 and 1 – and so we have recommended temozolomide for these patients. There was insufficient evidence to recommend temozolomide for other patient groups.
“NICE follows an open and transparent process which includes consultation and changes in draft recommendations are a result of this robust process.”
