NICE backs selective internal radiation therapy for advanced liver cancer

The UK’s National Institute for Health and Care Excellence (NICE) has recommended selective internal radiation therapy (SIRT) for the treatment of advanced liver cancer in final draft guidance.

NICE’s draft guidance recommends the use of SIR-Spheres – made by SIRTEX – and TheraSphere – made by Boston Scientific – for treating advanced liver cancer that can’t be removed surgically and when transarterial therapy is not appropriate.

The recommendation also specifies that these two therapies should only be considered for people with Child-Pugh grade A liver impairment.

Despite limited clinical trial data for SIRTs compared with other treatment options, NICE’s appraisal committee concluded that SIRT may have fewer and more manageable side effects compared to systemic therapy sorafenib.

Although SIR-Spheres and TheraSphere are slightly less clinically effective than sorafenib, they cost less.

The cost savings mean that these two therapies can be recommended as cost-effective options for people with Child-Pugh grade A liver impairment when conventional transarterial therapies are not appropriate.

“Unlike current systemic therapy for advanced liver cancer, which is given over a long time period and can have persistent side effects, SIRT is a locally targeted one-off treatment option,” said Meindert Boysen, deputy chief executive and director of the Centre for Health Technology Assessment at NICE.

“This draft guidance will provide people with advanced liver cancer the opportunity to benefit from an effective treatment which, importantly in terms of quality of life, is likely to have fewer and less severe side effects than standard systemic therapy,” he added.