1.1 Nivolumab is recommended, within its marketing authorisation, for adjuvant treatment of completely resected oesophageal or gastro‑oesophageal junction cancer in adults who have residual disease after previous neoadjuvant chemoradiotherapy. It is recommended only if the company provides nivolumab according to the commercial arrangement.
Why the committee made these recommendations
The most common treatment for oesophageal or gastro‑oesophageal junction cancer is neoadjuvant chemoradiotherapy then surgery. Treatment choice depends on various factors including histology, tumour size and location, patient preference and treatment suitability.
Clinical trial evidence shows that after trimodal therapy (chemoradiotherapy and surgery), nivolumab increases how long people live without the cancer returning compared with standard care, which is surveillance alone. Nivolumab is also likely to be more effective at extending how long people live, but clinical trial evidence is not yet available.
The cost-effectiveness estimates are within what NICE normally considers an acceptable use of NHS resources, so nivolumab is recommended.