NICE's draft decision: Catumaxomab not recommended for treating fluid build-up caused by advanced cancer
NICE has published draft guidance not recommending catumaxomab (Korjuny) for the treatment of malignant ascites (fluid build-up in the abdomen) caused by certain EpCAM-positive cancers when further anticancer treatment is no longer suitable.
Malignant ascites happen when too much fluid builds up inside of the abdomen, which causes swelling and bloating and sometimes pain and breathlessness.
EpCAM is a protein which is produced in many epithelial cancers. Ovarian cancer is the most common cause of malignant ascites, but it can happen in other cancers such as stomach, liver, bladder, bowel and pancreas.
The usual way of managing malignant ascites is through drainage (paracentesis).
This NICE appraisal was looking at adding whether a medication, catumaxomab, given alongside draining the fluid can help patients in this position with the goal of reducing the need for future drainings.
Catumaxomab is given through an intraperitoneal catheter, a tube that is put into the abdominal cavity. The drug is then infused in four increasing doses over ten days, each infusion taking between three and six hours.
Evidence from a clinical trial suggested that people who have catumaxomab after a drainage using large-volume paracentesis (LVP) have longer before needing another drainage than people who have this type of drainage alone.
Why did NICE make this decision?
Through the assessment of all available information, the committee concluded there is not enough evidence to determine whether catumaxomab offers benefit and is value for money in this population.
The evidence is uncertain because how long people live after having catumaxomab after an LVP compared with LVP alone is not clear. The trial used to show the benefit was done over 20 years ago in a different population and in a different clinical context to how drainage of ascites works at the moment in the NHS. Additionally, there is no evidence comparing catumaxomab with a different type of catheter which is the type that would be used in this situation on the NHS (an indwelling peritoneal catheter (IPC) which can be left in place longer for repeated drainage).
The committee also heard that the experience for the patient can be a burden, involving multiple hospital trips, and that many patients aren't able to complete the treatment in the ten day window due to their health and the side effects of the treatment.
Based on this, the committee decided they don't have suitable evidence to conclude that the treatment should be recommended.
This is a draft decision, and the consultation remains open. This doesn’t mean this medication won’t ever be made available on the NHS in England, but rather that NICE requires more information before making a final decision.
We are grateful for our supporters who shared their experiences with ascites with us, so that we could make sure your voices were heard in the discussions. We're also pleased that we could nominate a patient expert, Lynda, to share her story directly with the committee.
What happens next?
The draft guidance is open to consultation until 31st July 2026. You can feed back your opinions and add evidence to Ovarian Cancer Action’s response by sending us an email to info@ovarian.org.uk
Alternatively, you can comment directly as an individual through the NICE website
After this, the NICE committee will meet again to discuss all the evidence and make their final guidance.