NICE technology appraisal guidance
Issued: November 2009

Topotecan for the treatment of relapsed small-cell lung cancer

This is an extract from the guidance. The complete guidance is available at

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.