Highlights

In the first-line setting we can use olaparib obviously as per SOLO-1, in the second-line setting because in the NHS NICE did not think olaparib was beneficial enough to use in the second-line setting, I think they only allowed us to use it in the third-line setting and beyond. So, in the second-line setting, niraparib can be used for both BRCA and non-BRCA, and rucaparib can be used for BRCA and non-BRCA. So, now that we have rucaparib out there, to be honest I prefer using rucaparib to niraparib because I do not have to see them every week for blood counts, I do not have the hypertension issues, and it is just a bit easier.

So, Avastin in the first-line setting, the decision is made by NICE for us in the UK, so we can only use it in the way it is reimbursed. So, in England the first-line setting allows us to use Avastin if the patient is Stage IV, or inoperable, or Stage IIIc with residual disease. We also now currently as clinicians do not treat BRCA mutated patients with Avastin, we will give them olaparib.