Osimertinib for treating EGFR mutation-positive unresectable locally advanced non-small-cell lung cancer after platinum-based chemoradiotherapy

  • Technology appraisal guidance
  • TA1156
  • Published: 
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1 Recommendations

1.1

Osimertinib can be used, within its marketing authorisation, as an option to treat unresectable locally advanced (stage 3) non-small-cell lung cancer (NSCLC) in adults. It is an option when:

  • the tumours have epidermal growth factor receptor (EGFR) exon 19 deletions or exon 21 L858R substitution mutations, and

  • the cancer has not progressed during or after platinum-based chemoradiotherapy.

    Osimertinib can only be used if the company provides it according to the commercial arrangement.

What this means in practice

Osimertinib must be funded in the NHS in England for the condition and population in the recommendations, if it is considered the most suitable treatment option. Osimertinib must be funded in England within 90 days of final publication of this guidance.

There is enough evidence to show that osimertinib provides benefits and value for money, so it can be used routinely across the NHS in this population.

NICE has produced tools and resources to support the implementation of this guidance.

Why the committee made these recommendations

Usual treatment for unresectable locally advanced NSCLC with EGFR exon 19 deletions or exon 21 L858R substitution mutations that has not progressed (not got worse) after platinum-based chemoradiotherapy is best supportive care including surveillance (regular outpatient appointments and scans).

Clinical trial evidence shows that osimertinib increases how long people have before their condition gets worse compared with best supportive care. It may also increase how long they live, but this is uncertain.

There are also uncertainties in the economic model, including:

  • how long people live after their condition has got worse when having best supportive care or osimertinib

  • how long people receiving osimertinib have before their condition gets worse

  • the length of time people take osimertinib.

The cost-effectiveness estimates are within the range that NICE considers an acceptable use of NHS resources. So, osimertinib can be used.