Osimertinib with pemetrexed and platinum-based chemotherapy is recommended, within its marketing authorisation, as an option for untreated advanced non-small-cell lung cancer (NSCLC) in adults whose tumours have epidermal growth factor receptor (EGFR) exon 19 deletions or exon 21 (L858R) substitution mutations. Osimertinib with pemetrexed and platinum-based chemotherapy is only recommended if the company provides it according to the commercial arrangement.
Usual treatment for untreated advanced NSCLC with EGFR mutations is osimertinib alone.
Evidence from a clinical trial shows that, compared with osimertinib alone, osimertinib with pemetrexed and platinum-based chemotherapy increases how long it takes before a person's cancer gets worse and how long they live. The effect on how long people live is uncertain because there is limited evidence from clinical trials in the long term. There is also uncertainty in how long people have the treatment.
Despite this uncertainty, the most likely cost-effectiveness estimates are within the range that NICE considers an acceptable use of NHS resources. So, osimertinib with pemetrexed and platinum-based chemotherapy is recommended.