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1 Recommendations

1.1

Pembrolizumab with chemoradiotherapy (external beam radiation therapy followed by brachytherapy) should not be used for untreated International Federation of Gynecology and Obstetrics (FIGO) 2014 stage 3 to 4A locally advanced cervical cancer in adults.

1.2

This recommendation is not intended to affect treatment with pembrolizumab 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

Pembrolizumab with chemoradiotherapy 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 there is not enough evidence to determine whether pembrolizumab is value for money in this population.

Why the committee made these recommendations

Usual treatment for FIGO 2014 stage 3 to 4A locally advanced cervical cancer is chemoradiotherapy.

Clinical trial evidence shows that pembrolizumab with chemoradiotherapy increases how long people have before their cancer gets worse and how long they live compared with chemoradiotherapy alone.

There are uncertainties with the economic model. This is because of the assumptions used and the way the modelling was done.

Because of the uncertainties in the economic model it is not possible to determine the most likely cost-effectiveness estimates for pembrolizumab with chemoradiotherapy. More analyses are needed. So it should not be used.