In draft guidance released today (26 February 2020), NICE has approved lenalidomide (Revlimid) with rituximab as an option for previously treated follicular lymphoma (grade 1 to 3A) in adults.
Lenalidomide is the first approved targeted treatment for follicular lymphoma that is not an anti-CD20 antibody.
In the phase III AUGMENT trial reported last year in the Journal of Clinical Oncology, the addition of lenalidomide to rituximab significantly prolonged progression-free survival (PFS) in patients with relapsed or refractory indolent lymphoma. After median follow-up of 28.3 months median PFS was 39.4 months with lenalidomide plus rituximab vs 14.1 months with rituximab alone (hazard ratio [HR] 0.46; P<0.001).
NICE says confidential matching-adjusted indirect data presented to the appraisal committee showed an improvement in progression-free survival (PFS) and overall survival (OS) for lenalidomide with rituximab compared with R-CHOP and R-CVP. However, data on median PFS and OS are currently immature.
Although the combination of lenalidomide with rituximab costs more than rituximab with chemotherapy, the cost-effectiveness estimate is within the range that NICE normally considers an acceptable use of NHS resources.
The draft guidance is now open for public comment.
