NICE guidance - Carmustine implants and temozolomide for the treatment of newly diagnosed high-grade glioma

Summary points from the guidance (1):

• temozolomide, within its licensed indications, is recommended as an option for the treatment of newly diagnosed glioblastoma multiforme in patients with a World Health Organization (WHO) performance status of 0 or 1
• carmustine implants, within their licensed indications, are recommended as an option for the treatment of newly diagnosed high-grade glioma only for patients in whom 90% or more of the tumour has been resected
• treatment with carmustine implants should be provided only within specialist centres

Notes:

• WHO performance status classification categorises patients as:
  • 0: able to carry out all normal activity without restriction
  • 1: restricted in strenuous activity but ambulatory and able to carry out light work
  • 2: ambulatory and capable of all self-care but unable to carry out any work activities; up and about more than 50% of waking hours
  • 3: symptomatic and in a chair or in bed for greater than 50% of the day but not bedridden
  • 4: completely disabled; cannot carry out any self-care; totally confined to bed or chair

Reference:

1. NICE (June 2007). Carmustine implants and temozolomide for the treatment of newly diagnosed high-grade glioma.