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Tafasitamab with lenalidomide and rituximab for treating relapsed or refractory follicular lymphoma after 1 or more lines of systemic treatment [ID6413]

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1 Recommendations

1.1

Tafasitamab with lenalidomide and rituximab should not be used to treat relapsed or refractory follicular lymphoma (grades 1 to 3a) after 1 or more line of systemic treatment in adults.

1.2

This recommendation is not intended to affect treatment with tafasitamab with lenalidomide 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

These are NICE's draft recommendations. If these recommendations become final, tafasitamab with lenalidomide and rituximab would not be 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 tafasitamab with lenalidomide and rituximab is value for money in this population.

Why the committee made these recommendations

Usual treatment for relapsed or refractory follicular lymphoma after 1 or more lines of systemic treatment is lenalidomide plus rituximab. Other treatments include obinutuzumab plus bendamustine, combinations of chemotherapy plus rituximab-based treatment, and, after 2 or more lines of systemic treatment, epcoritamab.

Clinical trial evidence shows that, compared with lenalidomide plus rituximab alone, tafasitamab plus lenalidomide and rituximab increases how long people have before their condition gets worse. But it is unclear if it increases how long people live.

Tafasitamab plus lenalidomide and rituximab has not been directly compared in a clinical trial with epcoritamab, obinutuzumab with bendamustine or combinations of chemotherapy plus rituximab-based treatment. There are indirect comparisons, but the results are too uncertain to be used.

There are uncertainties in the economic model because it is unclear which approach is most appropriate for modelling differences in how long people live with the different treatments. These uncertainties are increased by assumptions about how well the treatments work in the long term.

Because of the uncertainties in the economic model and clinical evidence, it is not possible to determine the most likely cost-effectiveness estimates for tafasitamab plus lenalidomide and rituximab. So, it should not be used.