Topotecan for the Treatment of Relapsed Small-Cell Lung Cancer (TA184)

Technology Appraisal Guidance No. 184

Source: National Institute for Health and Care Excellence

1. Guidance

1.1  Oral topotecan is recommended as an option only for people with relapsed small-cell lung cancer for whom:

  • re-treatment with the first-line regimen is not considered appropriate and
  • the combination of cyclophosphamide, doxorubicin and vincristine (CAV) is contraindicated (for details of the contraindications to CAV see the summary of product characteristics for each of the component drugs).

1.2  Intravenous topotecan is not recommended for people with relapsed small-cell lung cancer.

1.3  People with relapsed small-cell lung cancer currently receiving oral topotecan who do not meet the criteria specified in 1.1, or who are receiving intravenous topotecan should have the option to continue their treatment until they and their clinicians consider it appropriate to stop.

The guidance shown above constitutes Section 1 of the full document. A copy of the full document and a summary of the evidence is available on the Internet at

An abridged version of this guidance (a 'quick reference guide') is also available. Printed copies of the quick reference guide can be obtained by contacting 0845 003 7783 or emailing and quoting reference number N2024. It is also available on the Internet at

This guidance represents the view of the Institute which was arrived at after careful consideration of the available evidence. Health professionals are expected to fully take it into account when exercising their clinical judgement. This guidance does not, however, override the individual responsibility of health professionals to make appropriate decisions in the circumstances of the individual patient, in consultation with the patient and/or guardian or carer.

© Copyright National Institute for Health and Care Excellence. All rights reserved. This material may be freely reproduced for educational and not for profit purposes within the NHS. No reproduction by or for commercial organisations is permitted without the express written permission of the Institute.

Enquiries concerning the guidance should be addressed to: National Institute for Health and Care Excellence, MidCity Place, 71 High Holborn, London WC1V 6NA. email:

Topotecan for the treatment of relapsed small-cell lung cancer
Issue Date: November 2009
Review Date: November 2012

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