NICE has published final draft guidance recommending Roche’s Tecentriq in combination with other therapies for metastatic non-squamous, non-small-cell lung cancer, after a new deal for the drug combination now means it is cost effective.
The recommendation is for use of the drug in combination with Avastin (bevacizumab), carboplatin and paclitaxel for patients who have not had treatment for their metastatic NSCLC before, and whose PD-L1 tumour proportion score is between 0% and 49%. Also when targeted therapy for epidermal growth factor receptor (EGFR)- positive or anaplastic lymphoma kinase (ALK)-positive NSCLC has failed.
The new deal was made on the basis that treatment with Tecentriq and Avastin is stopped at two years to reflect the fact that the cost-effectiveness evidence was limited to two years of treatment and the best length of treatment is unknown.
In trials, those who received carboplatin and paclitaxel live longer than those having the current treatment of pemetrexed plus carboplatin or cisplatin, with or without pemetrexed maintenance, as well as living for longer before their condition worsens.
The committee didn’t give the recommendation for untreated PD-L1-positive metastatic NSCLC in people whose PD-L1 tumour proportion score is at least 50%, because no cost-effectiveness analyses comparing this with the current treatment for this type of NSCLC were provided.
“This decision by NICE is fantastic news for people living with metastatic NSCLC in England and Wales, where the current outlook is generally poor. For patients to have access to a life-extending treatment is an important step forward in order to advance outcomes in this area. Every additional day of life provides more opportunities to share time with their families, their friends and loved ones,” said Paula Chadwick, chief executive of the Roy Castle Lung Cancer Foundation.
Over 46,000 new cases of lung cancer are diagnosed in the UK each year and around 87% of these cases are NSCLC.