Durvalumab is recommended as an option for treating locally advanced unresectable non-small-cell lung cancer (NSCLC) in adults whose tumours express programmed cell death ligand 1 (PD‑L1) on 1% or more of cells and whose disease has not progressed after platinum-based chemoradiation, only if:
they have had concurrent platinum-based chemoradiation
the company provides durvalumab according to the commercial arrangement.
This appraisal reviews the additional evidence collected as part of the Cancer Drugs Fund managed access agreement for durvalumab for treating locally advanced unresectable NSCLC in adults whose tumours express PD‑L1 on 1% or more of cells and whose disease has not progressed following platinum-based chemoradiation (NICE technology appraisal guidance 578).
The new evidence includes longer term data from the PACIFIC clinical trial and from people having treatment in the NHS while this treatment was available in the Cancer Drugs Fund. It shows that people having durvalumab live longer than those who have standard care, defined as routine surveillance and an annual CT scan.
While a different modelling approach would have been preferred, the cost-effectiveness estimates for durvalumab were considered sufficiently plausible. They are within what NICE considers to be an acceptable use of NHS resources. So, durvalumab is recommended.