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    Has all of the relevant evidence been taken into account?

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    Are the summaries of clinical and cost effectiveness reasonable interpretations of the evidence?

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1 Recommendations

1.1

Mirvetuximab soravtansine should not be used to treat folate receptor- alpha (FR-alpha)-positive, platinum-resistant, high-grade serous epithelial ovarian, fallopian tube or primary peritoneal cancer in adults after 1 to 3 lines of systemic treatment.

1.2

This recommendation is not intended to affect treatment with mirvetuximab soravtansine 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 healthcare professional consider it appropriate to stop.

What this means in practice

Mirvetuximab soravtansine is not required to be funded and should not be used routinely in the NHS in England for the condition and population in the recommendations.

This is because the available evidence does not suggest that mirvetuximab soravtansine is value for money in this population.

Why the committee made these recommendations

Usual treatment for FR-alpha-positive, platinum-resistant, high-grade serous epithelial ovarian, fallopian tube or primary peritoneal cancer after 1 to 3 lines of systemic treatment is chemotherapy.

Clinical trial evidence shows that mirvetuximab soravtansine increases how long people have before their condition gets worse and how long they live compared with chemotherapy.

But there are uncertainties in the economic model, including:

  • how health-related quality of life differs for people having mirvetuximab soravtansine and people having chemotherapy

  • how long people live after having mirvetuximab soravtansine and after having chemotherapy

  • the average age of people starting treatment.

Even when considering the condition's severity, and its effect on quality and length of life, the most likely cost-effectiveness estimates are above the range that NICE considers an acceptable use of NHS resources. So, mirvetuximab soravtansine should not be used.