topotecan (Hycamtin)

Following a full submission

topotecan (Hycamtin®) is accepted for restricted use within NHS Scotland in combination with cisplatin for patients with carcinoma of the cervix recurrent after radiotherapy and for patients with stage IVB disease. It is restricted to patients who are cisplatin-naïve.

In an open-label study, overall and progression-free survival were significantly longer for cisplatin plus topotecan compared with cisplatin alone. Haematological adverse events were more common in the cisplatin plus topotecan group.

The economic submission demonstrated that topotecan plus cisplatin was cost effective compared to cisplatin alone in cisplatin-naïve patients. However, the manufacturer’s justification of the treatment’s cost in relation to its health benefit was not sufficient to gain acceptance by SMC for use in patients with previous exposure to cisplatin.