In new draft guidance, NICE has decided not to recommend rucaparib (Rubraca) as maintenance treatment for relapsed ovarian, fallopian tube, or peritoneal cancer that has responded to platinum-based chemotherapy.
In the ARIEL3 trial, rucaparib was associated with a statistically significant improvement in progression-free survival (PFS) which was seen at data cut-off (median 10.8 months vs 5.4 months; hazard ratio [HR] 0.36; 95% CI 0.30-0.45).
However, data on overall survival are as yet immature. It is expected that the overall survival (OS) effects of rucaparib will be similar to other PARP inhibitors but at the cut-off date in ARIEL3, median OS was not reached and there was no statistically significant difference between the treatment arms.
In addition to this, the cost-effectiveness estimates are higher than what NICE normally considers an acceptable use of NHS resources.
The draft guidance is now open for public consultation. Consultees have the opportunity to comment on the draft recommendations until 27 August 2019. A final recommendation is expected to be published in late November.