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    Has all of the relevant evidence been taken into account?
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    Are the summaries of clinical and and cost effectiveness reasonable interpretations of the evidence?
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    Are the recommendations sound and a suitable basis for guidance to the NHS?
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The content on this page is not current guidance and is only for the purposes of the consultation process.

1 Recommendations

1.1 Pembrolizumab plus lenvatinib is not recommended, within its marketing authorisation, for treating advanced or recurrent endometrial cancer in adults who have disease progression on or after platinum-based chemotherapy and who cannot have surgery or radiotherapy.

1.2 This recommendation is not intended to affect treatment with pembrolizumab plus lenvatinib that was started in the NHS before this guidance was published. People having treatment outside this recommendation may continue without change to the funding arrangements in place for them before this guidance was published, until they and their NHS clinician consider it appropriate to stop.

Why the committee made these recommendations

There is no standard treatment for previously treated advanced or recurrent endometrial cancer. But people would usually have non-platinum-based chemotherapy.

Clinical evidence shows that pembrolizumab plus lenvatinib increases the time until the cancer gets worse and how long people live compared with non-platinum-based chemotherapy.

There is uncertainty in the economic model about how long people live in the long-term with pembrolizumab plus lenvatinib. The model also assumes that the effect of pembrolizumab plus lenvatinib continues for a person's lifetime after treatment stops, which is unlikely. Both these issues significantly affect the cost-effectiveness estimates. It is also difficult to know what the most likely estimates are because the most recent trial data has not been included. So, pembrolizumab plus lenvatinib is not recommended.