NICE Recommends Atezolizumab for Extensive-stage Small Cell Lung Cancer

Nicky Broyd

May 27, 2020

The National Institute for Health and Care Excellence (NICE) has reversed another decision on atezolizumab (Tecentriq, Roche) after getting a better NHS discount.

Draft guidance now recommends the PD-L1 inhibitor in combination with carboplatin and etoposide as an option for untreated extensive-stage small cell lung cancer (ES-SCLC).

Last week a similar decision was made for the same drug for triple negative breast cancer.

Cost Effective

NICE said the manufacturer had agreed on a new price with NHS England and Improvement making the drug a cost-effective use of NHS resources.

The full list price for a course of treatment delivered intravenously every 3 weeks is £32,798.39.

NICE cited clinical trial evidence from IMpower133 on atezolizumab with carboplatin and etoposide increasing the time before disease worsening by around one month, compared with standard chemotherapy, to 5.2 months.

Median overall survival was 12.3 months for atezolizumab combination therapy and 10.3 months for standard chemotherapy

Evidence of long-term benefit on overall survival was uncertain.

The guidance only recommends the treatment for patients with an Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1.

'Valuable Time'

ES-SCLC is an aggressive form of lung cancer accounting for 1 in 8 lung cancer cases in the UK. It's estimated that around half of the 2400 people in England with ES-SCLC will be eligible for the new combination treatment.

Meindert Boysen, deputy chief executive officer and director of the Centre for Health Technology Evaluation at NICE, said in a news release: "I know how important this news will be for patients suffering with this condition, for which there are currently few treatment options. Atezolizumab with carboplatin and etoposide may offer valuable time for patients to spend with their loved ones.”

Final guidance is expected next month.

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