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Acalabrutinib with bendamustine and rituximab for untreated mantle cell lymphoma

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1 Recommendations

1.1

Acalabrutinib plus bendamustine and rituximab should not be used for untreated mantle cell lymphoma in adults who are not eligible for an autologous stem cell transplant.

1.2

This recommendation is not intended to affect treatment with acalabrutinib plus bendamustine and rituximab 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

Acalabrutinib plus bendamustine and rituximab 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 if acalabrutinib plus bendamustine and rituximab is value for money in this population.

Why the committee made these recommendations

Usual treatment for untreated mantle cell lymphoma in adults who cannot have an autologous stem cell transplant is bendamustine plus rituximab.

Clinical trial evidence shows that acalabrutinib plus bendamustine and rituximab increases how long people have before their condition gets worse compared with usual treatment.

There are uncertainties in the economic model. This is because of its structure and the assumptions used.

Because of the uncertainties in the economic model it is not possible to determine the most likely cost-effectiveness estimates for acalabrutinib plus bendamustine and rituximab.

So, acalabrutinib plus bendamustine and rituximab should not be used.