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NICE scopes Sanofi/Regeneron's Zaltrap for colorectal cancer

This article was originally published in Scrip

Sanofi/Regenron's Zaltrap (aflibercept) will shortly be up for review by NICE, the health technology appraisal institute for England and Wales, as a treatment for metastatic colorectal cancer that has progressed after oxaliplatin-based chemotherapy. The institute has put out for consultation its draft scope.

NICE will review the drug when used in combination with irinotecan and fluorouracil-based therapy, although any recommendations will be contingent on marketing authorisation. However, NICE expects to be able to publish guidance in the second half of 2013.

According to NICE's draft scope, the institute wants to consider the following outcomes: overall survival; progression-free survival; response rate; adverse effects of treatment; and health-related quality of life. Meanwhile, suitable comparators could be irinotecan in combination with fluorouracil-based therapy and irinotecan alone, suggests NICE. Infusional fluorouracil plus folinic acid and irinotecan are currently recommended as treatment options following first-line chemotherapy.

The management of metastatic colorectal cancer is largely palliative, involving symptom control and psychosocial support as well as treatments such as surgery, chemotherapy and radiation. The institute has already turned down several treatments for metastatic colorectal cancer.

Earlier this year it published final and binding guidance on Merck Serono's Erbitux (cetuximab), Roche's Avastin (bevacizumab) and Amgen's Vectibix (panitumumab) for mCRC that has progressed after first-line chemotherapy (scripintelligence.com, 25 November 2011). The institute had been concerned about the high cost-effective estimates for Erbitux and Vectibix, while it had doubts over how well Avastin would extend life when used as a second-line therapy.

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