1.1 Pembrolizumab is recommended, within its marketing authorisation, as an option for the adjuvant treatment of renal cell carcinoma at increased risk of recurrence after nephrectomy, with or without metastatic lesion resection, in adults. It is recommended only if the company provides it according to the commercial arrangement.
Why the committee made these recommendations
People who have had renal cell carcinoma that has been treated surgically with either a partial or radical nephrectomy, and that is at increased risk of recurrence, have routine surveillance (regular monitoring) as follow up. Pembrolizumab plus routine surveillance is a possible option as an adjuvant treatment (that is, after surgery).
Evidence from a clinical trial suggests that, after surgery, pembrolizumab plus routine surveillance increases the time people have before their cancer comes back and how long they live compared with placebo plus routine surveillance.
The cost-effectiveness estimates for pembrolizumab as adjuvant treatment are within the range that NICE normally considers an acceptable use of NHS resources. So, it is recommended.