SMC approves Glivec for GIST

The Scottish Medicines Consortium (SMC) has approved the use of Novartis' imatinib (Glivec/Gleevec) within NHS Scotland for use in the adjuvant treatment of adults who are at a high risk of recurrence following complete resection of Kit (CD117)-positive gastrointestinal stromal tumours (GIST).

The drug advice notes that imatinib, given for a period of one year, significantly improved the estimated one year recurrence-free survival compared with placebo and was associated with an increase of 16.4 months in median time to recurrence in patients at high risk of relapse following resection. The economic case was demonstrated for a one-year adjuvant treatment duration only.

The SMC's decision is in contrast to the National Institute for Health and Clinical Excellence's (NICE) decision to reject the drug for use in England and Wales in August.

NICE stated that although there is evidence that giving imatinib as adjuvant post-surgery therapy can delay the recurrence of GIST, there is a lack of evidence relating to the clinical effectiveness of imatinib, in particular whether adjuvant imatinib extends life expectancy, how long treatment should be continued and whether resistance to imatinib develops.