1.1 Polatuzumab vedotin with rituximab and bendamustine is 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. It is recommended only if the company provides polatuzumab vedotin according to the commercial arrangement.
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. It also suggests that they live longer.
Polatuzumab vedotin plus rituximab and bendamustine is considered to be a life-extending treatment at the end of life. The cost-effectiveness estimates are within the range that NICE considers an acceptable use of NHS resources. Therefore, polatuzumab vedotin plus rituximab and bendamustine is recommended.