1 Recommendations
1.1 Pembrolizumab with platinum- and fluoropyrimidine-based chemotherapy is recommended, within its marketing authorisation, as an option for untreated locally advanced unresectable or metastatic carcinoma of the oesophagus or HER2‑negative gastro-oesophageal junction adenocarcinoma in adults whose tumours express PD‑L1 with a combined positive score (CPS) of 10 or more. Pembrolizumab is only recommended if the company provides it according to the commercial arrangement.
Why the committee made these recommendations
Treatment for advanced oesophageal cancer or HER2‑negative gastro-oesophageal junction adenocarcinoma includes platinum- and fluoropyrimidine-based chemotherapy. Clinical trial evidence shows that for people whose tumours express PD‑L1 with a CPS of 10 or more, adding pembrolizumab increases how long they live. It also increases the time before their disease gets worse.
Pembrolizumab meets NICE's criteria to be considered a life-extending treatment at the end of life. The cost-effectiveness estimates are likely to be within what NICE considers an acceptable use of NHS resources. Therefore, it is recommended.