Polatuzumab vedotin with rituximab and bendamustine for treating relapsed or refractory diffuse large B‑cell lymphoma
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1.1 Polatuzumab vedotin with rituximab and bendamustine is not recommended, within its marketing authorisation, as an option for treating relapsed or refractory diffuse large B‑cell lymphoma in adults who cannot have a haematopoietic stem cell transplant.
1.2 This recommendation is not intended to affect treatment with polatuzumab vedotin with rituximab and bendamustine 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 relapsed or refractory diffuse large B‑cell lymphoma in people who cannot have a haematopoietic stem cell transplant. They could be offered rituximab with bendamustine, although this is not standard care in the NHS. Clinical evidence shows that people having polatuzumab vedotin plus rituximab and bendamustine have more time before their disease gets worse than people having rituximab and bendamustine alone. The evidence also suggests that they live longer, but it is not known by how much because the final data from the trial are not available yet.
The cost-effectiveness estimates for polatuzumab vedotin with rituximab and bendamustine are very uncertain because of limitations in the data and methods. It is considered a life-extending treatment at the end of life, but the cost-effectiveness estimates are too uncertain. Therefore, it cannot be recommended for routine use in the NHS or for use in the Cancer Drugs Fund.