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NICE recommends atezolizumab for NSCLC

NICE has issued new guidance on the use of atezolizumab (Tecentriq) for treating locally advanced or metastatic non-small-cell lung cancer (NSCLC) after chemotherapy.

NICE recommends atezolizumab (Tecentriq) as an option for treating locally advanced or metastatic NSCLC in adults who have had chemotherapy (and targeted treatment if they have an EGFR- or ALK‑positive tumour). Atezolizumab should be stopped after two years of uninterrupted treatment or earlier if the disease progresses.

The decision follows negotiation of a discounted cost for the medication as part of a patient access scheme. However, there will be no change in funding arrangements for patients who had already been initiated on atezolizumab prior to the new recommendations being published.

Published trials have shown that atezolizumab confers a survival benefit over docetaxel alone in this patient population. There is no evidence directly comparing atezolizumab with pembrolizumab, but NICE says indirect analyses show that for people with PD‑L1‑positive disease, there may be no difference in survival benefit for atezolizumab compared with pembrolizumab. Atezolizumab meets NICE's criteria to be considered a life-extending treatment compared with docetaxel alone, but not compared with pembrolizumab.

NICE said: “The most plausible cost-effectiveness estimates for atezolizumab, compared with docetaxel (for PD‑L1‑negative disease) and with pembrolizumab (for PD‑L1‑positive disease), are within the range NICE considers an acceptable use of NHS resources. Therefore, it can be recommended after chemotherapy for locally advanced or metastatic NSCLC.”


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