NICE Approves Lynparza for Breast Cancer

who have had: i) an anthracycline and a taxane as neoadjuvant or adjuvant treatment, or for metastatic disease, unless these are not suitable, and ii) endocrine therapy if they have hormone receptor (HR)-positive breast cancer, unless this is not suitable. Olaparib is only recommended if the company provides it according to the commercial arrangement. If people with the condition and their healthcare professional, after discussing the advantages and disadvantages of all the options, consider olaparib to be 1 of a range of suitable treatments, the lowest cost option should be used. Administration costs, dosages, price per dose and commercial arrangements should all be taken into account. Why these recommendations were made: HER2-negative, locally advanced or metastatic breast cancer with germline BRCA1 or BRCA2 mutations is usually treated with an anthracycline and a taxane (chemotherapy). If the breast cancer is also HR positive, endocrine therapy with chemotherapy may also be used. Usual treatment after chemotherapy, and endocrine therapy if appropriate, is more chemotherapy or talazoparib. Clinical trial evidence shows that people who have olaparib have longer before their cancer gets worse than people who have chemotherapy. Olaparib has not been directly compared with talazoparib in a clinical trial. But an indirect comparison suggests that it is likely to work as well as talazoparib. A cost comparison suggests olaparib has similar or lower costs than talazoparib when all relevant costs are taken into account including commercial agreements. So olaparib is recommended.