[NICE Technology Appraisal Guidance] Lenalidomide with rituximab for previously treated follicular lymphoma

NICE | April 2020 | Lenalidomide with rituximab for previously treated follicular lymphoma |Technology appraisal guidance [TA627]

NICE has produced evidence-based recommendations on lenalidomide (Revlimid) with rituximab for previously treated follicular lymphoma (grade 1 to 3A) in adults.

Full details form NICE 

Lenalidomide with rituximab for previously treated follicular lymphoma

NICE Guideline: COVID-19 rapid guideline: delivery of systemic anticancer treatments

NICE | March  2020 |COVID-19 rapid guideline: delivery of systemic anticancer treatments

NICE guideline [NG161]

The purpose of this guideline is to maximise the safety of patients with cancer and make the best use of NHS resources, while protecting staff from infection. It will also enable services to match the capacity for cancer treatment to patient needs if services become limited because of the COVID-19 pandemic.

On 3 April 2020, NICE added 2 recommendations on when to offer and continue systemic anticancer treatment for patients with COVID-19. NICE also amended the table on prioritising treatments in line with new advice from NHS England.

 

This guideline is for:

  • health and care practitioners
  • health and care staff involved in planning and delivering services
  • commissioners

Further information availlable from NICE 

NICE has also produced a COVID-19 rapid guideline on delivery of radiotherapy.

COVID-19 rapid guideline: delivery of radiotherapy

NICE | March 2020| COVID-19 rapid guideline: delivery of radiotherapy

The purpose of this guideline is to maximise the safety of patients who need radiotherapy and make the best use of NHS resources, while protecting staff from infection. It will also enable services to match the capacity for radiotherapy to patient needs if services become limited because of the COVID-19 pandemic.

NICE has also produced a COVID-19 rapid guideline on delivery of systemic anticancer treatments.

This guideline is for:

  • health and care practitioners
  • health and care staff involved in planning and delivering services
  • commissioners

Full details from NICE

COVID-19 rapid guideline: delivery of radiotherapy NICE guideline

NICE |  March 2020 | COVID-19 rapid guideline: delivery of radiotherapy [NG162]

The purpose of this guideline is to maximise the safety of patients who need radiotherapy and make the best use of NHS resources, while protecting staff from infection. It will also enable services to match the capacity for radiotherapy to patient needs if services become limited because of the COVID-19 pandemic.

This guidance was first published on 28 March 2020.

NICE has also produced a COVID-19 rapid guideline on delivery of systemic anticancer treatments.

This guideline is for:

  • health and care practitioners
  • health and care staff involved in planning and delivering services
  • commissioners

The recommendations bring together

  • existing national and international guidance and policies
  • advice from specialists working in the NHS from across the UK. These include people with expertise and experience of treating patients for the specific health conditions covered by the guidance during the current COVID-19 pandemic.

Full details from NICE

Ovarian cancer disease profile

Disease profile in England: Incidence, mortality, stage and survival for ovary, fallopian tube and primary peritoneal carcinomas |  Public Health England

This report provides a detailed insight into the status of ovarian cancer in England.  It is the first report from the Cancer Audit Feasibility Pilot project which runs for two years and includes details of disease incidence, mortality and survival.

Amount and intensity of leisure-time physical activity and lower cancer risk

Matthews, C. E. et al. | Amount and Intensity of Leisure-Time Physical Activity and Lower Cancer Risk | Journal of Clinical Oncology | published online December 26th 2019.

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Purpose
To determine whether recommended amounts of leisure-time physical activity (ie, 7.5-15 metabolic equivalent task [MET] hours/week) are associated with lower cancer risk, describe the shape of the dose-response relationship, and explore associations with moderate- and vigorous-intensity physical activity.

Methods
Data from 9 prospective cohorts with self-reported leisure-time physical activity and follow-up for cancer incidence were pooled. Multivariable Cox regression was used to estimate adjusted hazard ratios (HRs) and 95% CIs of the relationships between physical activity with incidence of 15 types of cancer. Dose-response relationships were modeled with restricted cubic spline functions that compared 7.5, 15.0, 22.5, and 30.0 MET hours/week to no leisure-time physical activity, and statistically significant associations were determined using tests for trend (P < .05) and 95% CIs (< 1.0).

Results
A total of 755,459 participants (median age, 62 years [range, 32-91 years]; 53% female) were followed for 10.1 years, and 50,620 incident cancers accrued. Engagement in recommended amounts of activity (7.5-15 MET hours/week) was associated with a statistically significant lower risk of 7 of the 15 cancer types studied, including colon (8%-14% lower risk in men), breast (6%-10% lower risk), endometrial (10%-18% lower risk), kidney (11%-17% lower risk), myeloma (14%-19% lower risk), liver (18%-27% lower risk), and non-Hodgkin lymphoma (11%-18% lower risk in women). The dose response was linear in shape for half of the associations and nonlinear for the others. Results for moderate- and vigorous-intensity leisure-time physical activity were mixed. Adjustment for body mass index eliminated the association with endometrial cancer but had limited effect on other cancer types.

Conclusion
Health care providers, fitness professionals, and public health practitioners should encourage adults to adopt and maintain physical activity at recommended levels to lower risks of multiple cancers.

Full document available at Journal of Clinical Oncology

New blood test for prostate cancer is highly-accurate and avoids invasive biopsies

Queen Mary University | September 2019 | New blood test for prostate cancer is highly-accurate and avoids invasive biopsies

A blood test developed by experts at Queen Mary University marks a ‘paradigm shift’ in the way prostate cancer is diagnosed. 

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The new prostate cancer test detects early cancer cells, or circulating tumor cells (CTCs), that have left the original tumour and entered the bloodstream prior to spreading around the body. By measuring intact living cancer cells in the patient’s blood, rather than the PSA protein which may be present in the blood for reasons other than cancer, it potentially provides a more accurate test for prostate cancer.

The study tested the use of the CTC test in 98 pre-biopsy patients and 155 newly diagnosed prostate cancer patients enrolled at St Bartholomew’s Hospital in London.

The research team found that the presence of CTCs in pre-biopsy blood samples were indicative of the presence of aggressive prostate cancer, and efficiently and non-invasively predicted the later outcome of biopsy results.

When the CTC tests were used in combination with the current PSA test, it was able to predict the presence of aggressive prostate cancer in subsequent biopsies with over 90 per cent accuracy, better than any previously reported biomarkers.

Additionally, the number and type of CTCs present in the blood was also indicative of the aggressiveness of the cancer. Focusing on more aggressive prostate cancer may reduce over-treatment and unnecessary biopsies for benign and non-aggressive conditions.

(Source Queen Mary University) 

Full reference: Xu, L. | 2019|Non-invasive Detection of Clinically Significant Prostate Cancer Using Circulating Tumor Cells | Journal of Urology | https://doi.org/10.1097/JU.0000000000000475

Purpose:

PSA testing results in unnecessary biopsy and over-diagnosis with consequent over-treatment. Tissue biopsy is an invasive procedure, associated with significant morbidity. More accurate non- or minimum-invasive diagnostic approaches should be developed to avoid unnecessary prostate biopsy and over-diagnosis. We investigated the potential of using circulating tumor cell analysis in cancer diagnosis, particularly in predicting clinically significant prostate cancer in pre-biopsy patients.

Material and Methods:

We enrolled 155 treatment naïve prostate cancer patients and 98 pre-biopsy patients for circulating tumor cell numeration. RNA was extracted from circulating tumor cells from 184 patients for gene expression analysis. Kruskal-Wallis, Spearman’s rank, multivariate logistic regression and random forest were applied to assess the association of circulating tumor cells with aggressive prostate cancer.

Results:

In localized prostate cancer patients, 54% were scored as circulating tumor cell positive, which was associated with higher Gleason score ( p=0.0003), risk group ( p<0.0001) and clinically significant prostate cancer. In pre-biopsy group, positive circulating tumor cell score in combination with PSA predicted clinically significant prostate cancer with AUC=0.869. A 12-gene panel prognostic for clinically significant prostate cancer was also identified. Combining PSA level, circulating tumor cell-score and the 12-gene panel, AUC for clinically significant prostate cancer prediction was 0.927 and in cases with multi-parametric MRI data, adding these to multi-parametric MRI significantly increased the prediction accuracy.

Conclusions:

Circulating tumor cell analysis has the potential to significantly improve patient stratification by PSA and/or multi-parametric MRI for biopsy and treatment.

The Library can provide the full article to Rotherham NHS Staff, request here

 

See also:

Science Daily New blood test for prostate cancer is highly-accurate and avoids invasive biopsies

Ribociclib with fulvestrant for treating hormone receptor-positive, HER2-negative, advanced breast cancer

NICE | August 2019 | Ribociclib with fulvestrant for treating hormone receptor-positive, HER2-negative, advanced breast cancer| Technology Appraisal Guidance

NICE has published Evidence-based recommendations on ribociclib (Kisqali) for hormone receptor-positive, human epidermal growth factor receptor 2 (HER2)-negative, locally advanced or metastatic breast cancer in adults who have had previous endocrine therapy.

Ribociclib with fulvestrant for treating hormone receptor-positive, HER2-negative, advanced breast cancer

See also:

Breast cancer drugs option joins cancer drugs fund

 

Olaparib for maintenance treatment of BRCA mutation-positive advanced ovarian, fallopian tube or peritoneal cancer after response to first-line platinum-based chemotherapy

NICE |  August 2019 | Olaparib for maintenance treatment of BRCA mutation-positive advanced ovarian, fallopian tube or peritoneal cancer after response to first-line platinum-based chemotherapy

Olaparib (Lynparza) is available through the Cancer Drugs Fund. It is a possible treatment for advanced ovarian, fallopian tube or peritoneal cancer in adults, if:

  • they have a BRCA mutation and
  • the cancer has been treated with 1 course of platinum-based chemotherapy.

More evidence on olaparib is being collected, until September 2023. After this, NICE will decide whether or not to recommend it for use on the NHS and update the guidance. It will be available through the Cancer Drugs Fund until then.

Full details from NICE