NICE: pembrolizumab for urothelial carcinoma after platinum chemotherapy


  • Dawn O'Shea
  • Oncology drug update
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Draft guidance from NICE does not recommend pembrolizumab for the treatment of locally advanced or metastatic urothelial carcinoma in adults who have had platinum-containing chemotherapy.

Pembrolizumab for previously treated locally advanced or metastatic urothelial carcinoma was recommended for use in the Cancer Drugs Fund last year. This new NICE appraisal reviews the evidence collected since the treatment became available through the Cancer Drugs Fund.

The guidance states that while pembrolizumab meets NICE's criteria to be considered a life-extending treatment at the end of life, the most likely cost-effectiveness estimate for the treatment remains uncertain. Even when pembrolizumab is offered with its agreed discount, the most plausible cost-effectiveness estimate remains above what NICE normally considers acceptable for end-of-life treatments. Therefore, the draft guidance states, pembrolizumab is not recommended.

Pembrolizumab may not remain in the Cancer Drugs Fund for this indication once the guidance review has been completed.

NICE proposes that this guidance should be considered for review in 3 years’ time.

The draft decision is now open for public comment. The deadline for receipt of comments is Thursday, December 5.

Further information is available here.