July 29, 2011 – The National Institute for Health and Clinical Excellence (NICE) has announced that it has produced guidance to support the routine use of selective internal radiation therapy (SIRT) for the treatment of patients with liver tumors resulting from colorectal cancer. This welcome decision culminates an extensive dialogue between patients, patient groups, clinical experts and parliamentarians.
SIRT is used for the treatment of inoperable liver tumors and involves injecting millions of tiny radioactive microspheres into the liver via the hepatic artery. Each microsphere is coated with a radioactive isotope that emits beta radiation. The radiation delivers a localized treatment to tumor cells while conserving normal liver cells. SIR-Spheres microspheres, a form of SIRT, were approved in Europe in 2002 and at least 18,000 patients have been treated worldwide. Three hundred patients have received the treatment in Britain. The NICE guidance, released on July 27, 2011, found there is evidence that SIRT controls liver tumors from colorectal cancer, meaning that eligible National Health Service (NHS) patients are now likely to have improved access to this treatment.
Disproportionate access to SIRT has been of great concern to many cancer patients, as the treatment can potentially extend life by years. SIRT was originally assessed in 2004 and during the more recent reassessment there has been confusion among primary care trusts (PCTs) as to whether they should fund the treatment for eligible patients on the NHS. The reassessment of SIRT has taken NICE two years to complete.
In May 2010, the plight of Becky Smith, M.D., a 30-year-old NHS surgeon who was refused SIRT treatment by the Isle of Wight PCT because of funding issues, was highlighted by the national media. After receiving national support and offers of funding from individuals, Smith was told that the Isle of Wight PCT had made a dramatic U-turn and decided to fund her treatment. Smith has been campaigning for the government to change the system to make this life-saving treatment available to all who need it.
Smith said, "I have without doubt benefited from treatment with SIRT, which has given me precious time to live life to the full. It is great that NICE has supported the use of SIRT; however, this decision should have been made much sooner. I hope that this means all eligible patients will get the treatment that they deserve on the NHS."
Harpreet Wasan, M.D., consultant oncologist at Hammersmith Hospital, Imperial College, said, "SIRT is a pioneering treatment which provides an innovative therapy for patients with inoperable liver tumors that complements chemotherapy. It is excellent news that NICE has now clarified its guidance with the latest evidence and this should ensure appropriately eligible patients can access SIRT on the NHS. I hope that as a result, postcode prescribing and lengthy delays in approving eligible patients for the treatment will be eradicated."
For more information: www.guidance.nice.org.uk/ipg401