NICE ACD on 2nd line CML therapy published today

This release was made on 6 May 2011.  The period for submitting comments to NICE has now closed. 

NICE has today issued an appraisal consultation document (ACD) reviewing the use of dasatinib, nilotinib and high dose imatinib as a second line therapy for patients with CML.  This states that dasatinib, nilotinib and high dose imatinib are not recommended for the treatment of CML that is resistant to standard dose imatinib.  People who are currently receiving dasatinib, nilotinib or high dose imatinib for imatinib-resistant CML may however continue. A separate technology appraisal looking at imatinib intolerance is ongoing.  

The haematology community in the UK takes a very responsible position in contributing to evidence-based medicine in CML as has been demonstrated by the excellent support that SPIRIT 2 receives from clinicians around the country. We are trying our very best to provide the sort of long-term evidence that NICE demand for first-line therapy. For second line therapy nilotinib and dasatinib have been shown to be effective in many patients and these drugs have undoubtedly saved lives. We know that up to 40% of patients on imatinib end up being unable to take the drug and to force these patients towards hydroxycarbamide would be a backward step in the treatment of CML in the UK. It is also not a large number of patients that may required 2nd generation TKIs so the financial impact would not be that great, especially when one considers the cost of alternative supportive care.

It is important that as many people as possible (including clinicians and patients, their families, carers and friends) use the opportunity to comment on this ACD and express any concerns they might have about this decision. Anyone can contribute their comments. There is a short period of time in which to do this and the deadline for comments is 5.00pm on Friday 27 May 2011.  We wanted to make sure that you knew about this draft guidance and had the opportunity to comment, and ask others to do so, if you are concerned. 

You can view the NICE announcement here

You and your patients can have your say in a number of ways:  
1.  Respond directly to NICE with your comments.  Details of how to do this through the NICE website are here.  You can also write to NICE at their Manchester Office or preferably email: the project manager is 

2.  Write to your MP. You can ask him/her to put questions to ministers during parliamentary sessions and/or attend MPs surgeries.  You can find out who your MP is here.  You can also write to the Secretary of State for Health and regional MEPs. 

3. Sign the CML Support Group petition which will be available this weekend on their website at  You can also view their press statement here.

It is important that as many individual healthcare professionals, patients, friends and family members contribute comments and we encourage you to use this opportunity to do so.

Last modified: Fri, 20 Jan 2017 13:20:54 GMT