Nivolumab with ipilimumab and chemotherapy for untreated metastatic non-small-cell lung cancer: Appraisal consultation document
DRAFT guidance does not recommend nivolumab plus ipilimumab and 2 cycles of platinum-based chemotherapy for untreated metastatic non-small-cell lung cancer in adults whose tumours have no epidermal growth factor receptor or anaplastic lymphoma kinase mutations.
Source:
National Institute for Health and Care Excellence
SPS commentary:
The Appraisal committee noted that the nivolumab combination is only likely to meet NICE’s end of life criteria for squamous NSCLC with a PD-L1 TPS below 50%. The cost-effectiveness estimates for nivolumab combination compared with platinum-doublet chemotherapy, atezolizumab combination and pembrolizumab monotherapy are higher than what NICE considers acceptable. This is even when the end of life criteria are applied for squamous NSCLC with a PD-L1 TPS below 50%. It was concluded that collecting more data in the Cancer Drugs Fund would be unlikely to resolve the uncertainty in the modelling.