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Briefing note: bevacizumab (Avastin)

SMC did not accept bevacizumab in combination with carboplatin and paclitaxel for the front-line treatment of advanced (FIGO stages III B, III C and IV) epithelial ovarian, fallopian tube, or primary peritoneal cancer.

  • Ovarian cancer is the fifth most common cause of death from cancer in women.  Cancer of the ovaries (female reproductive organs) commonly starts in cells of the surface lining the ovaries called the epithelium and this type is known as epithelial ovarian cancer. Cancer can also affect other parts of the female reproductive system such as the fallopian tubes (tubes that link the ovaries to the womb). Cancer occurring in the lining of the abdomen (peritoneum) is known as primary peritoneal cancer and this rare cancer behaves in a similar way to epithelial ovarian cancer.
     
  • Cancer chemotherapy is given to try and kill cancer cells or stop them spreading further. Bevacizumab is given in combination with other cancer chemotherapy medicines. This medicine helps block the growth of new blood vessels that supply the cancer cells with nutrients. Bevacizumab is given once every 3 weeks as an intravenous infusion.
     
  • In two studies, patients with advanced ovarian cancer receiving bevacizumab plus carboplatin and paclitaxel survived without cancer progression by 4 months longer compared with those receiving only carboplatin and paclitaxel.
     
  • SMC did not accept bevacizumab for use because the main economic case submitted by the company was based on an unlicensed dose of the medicine and this is not within the SMC remit. Additional economic analysis was provided using the licensed dose of the medicine. However, there were weaknesses in this economic case and in addition, the justification of costs in relation to the benefits meant the medicine was not considered to offer value for money.