re: NICE guidelines - Hundreds more breast cancer patients should be tested for BRCA1 gene

Target Ovarian Cancer Calls On DOH To Launch National Symptom Awareness Campaign As New NICE Guidance Stresses Importance Of Early Diagnosis, UK

Note: media story regarding new NICE guidelines for ovarian cancer

April 2011: NICE Guidelines - Ovarian cancer: the recognition and initial management of ovarian cancer

The recognition and initial management of ovarian cancer

Description

This clinical guideline offers evidence-based advice on the care and early treatment of women with suspected or confirmed ovarian cancer.
This guidance updates and replaces recommendation 1.7.4 in Referral guidelines for suspected cancer (NICE clinical guideline 27; published 2005).

Guidance documents

• Full guideline PDF format  | MS Word format
• NICE guideline PDF format  | MS Word format
• Quick reference guide PDF format
• NICE guidance written for patients and carers PDF format  | MS Word format
• CG122 Ovarian cancer: guidance (web format)

Implementing this guidance

• Baseline assessment tool
• Clinical audit tool
• Clinical case scenarios
• Costing statement
• Slide set

• CG122 Ovarian cancer: GP podcast
• CG122 Ovarian cancer: SLR podcast

Other information

• Background information

About this guidance

Clinical guidelines CG122

Issued: April 2011
How this guidance was produced

Order printed copies of this guidance

This page was last updated: 27 April 2011

NICE Unable To Recommend Ovarian Cancer Drug In Final Guidance Due To Lack Of Appropriate Evidence (trabectedin (Yondelis)

Apr 2011: free full access - Recognition and initial management of ovarian cancer: summary of NICE guidance -- bmj.com

Note: guidelines include Carboplatin alone in high-risk early stage; IP for advanced stage ovarian cancer via clinical trial/s (which brings up the question as to the availability of trials??) Future research What is the relationship between the duration and frequency of symptoms in women with ovarian cancer before diagnosis, and the stage of disease at diagnosis and subsequent survival? What is the optimum threshold on the risk of malignancy index I (RMI I) that should be applied in secondary care to guide the management of women with suspected ovarian cancer? How does computed tomography compare with magnetic resonance imaging in accuracy of staging and prediction of optimal cytoreduction? Answering this will require large, multicentre case-control studies. What are the cost effectiveness and risks of systematic retroperitoneal lymphadenectomy in women whose ovarian cancer seems to be confined to the ovaries? Answering this will require a prospective randomised trial. What is the effectiveness of primary surgery in women with advanced ovarian cancer that cannot be fully excised?

media - NICE issues first GP ovarian cancer guidance highlighting four red flags

Detecting ovarian cancer in primary care


• Refer urgently if physical examination identifies a pelvic or abdominal mass and/or ascites.
• Investigate if a woman reports any of the following more than 12 times a month: abdominal distension, difficulty eating and/or feeling full, pelvic or abdominal pain or increased urinary urgency and/or frequency
• Also consider testing woman with abnormal vaginal bleeding, unexplained weight loss, abdominal distension, fatigue or changes in bowel habit.
• Send women with a serum CA125 35 IU/ml for an ultrasound scan and refer with a positive scan urgently for further investigation.
• Advise any woman who has normal serum CA125, or a normal ultrasound, to return to her GP for re-assessment if her symptoms persist or become more frequent.

Source: The recognition and initial management of ovarian cancer, draft NICE guideline, September 2010

Regulator to reject ovarian cancer treatment approve Trabectedin (Yondelis)

18th June 2010 - The health regulator, "The National Institute for Health and Clinical Excellence (NICE), says a new treatment for ovarian cancer is not recommended for the NHS because the manufacturer did not submit sufficient evidence that the medication benefits patients more than the most widely-used treatments.

NICE is appraising trabectedin (Yondelis) in combination with pegylated liposomal doxorubicin (PLDH) for the treatment of relapsed ovarian cancer that is sensitive to platinum-based therapies.

Its independent advisory found that the evidence submitted by the manufacturer was not robust because it did not compare trabectedin against a current ‘gold-standard’ treatment for relapsed ovarian cancer: paclitaxel in combination with platinum-based chemotherapy. This meant NICE couldn’t confirm whether or not the treatment extends patients’ lives for longer than one of the more effective and commonly-used treatments...."