Nivolumab with chemotherapy is recommended, within its marketing authorisation, as an option for the neoadjuvant treatment of resectable (tumours at least 4 cm or node positive) non-small-cell lung cancer (NSCLC) in adults. It is only recommended if the company provides it according to the commercial arrangement.
Standard care for NSCLC that can be surgically removed (resectable) is surgery. Sometimes chemoradiotherapy before (neoadjuvant) or chemotherapy after (adjuvant) surgery is also used.
There is no clinical trial evidence directly comparing neoadjuvant nivolumab plus chemotherapy with standard care but an indirect comparison suggests it is more effective.
The cost-effectiveness estimates for neoadjuvant nivolumab with chemotherapy compared with standard care are within the range NICE normally considers an acceptable use of NHS resources. So, neoadjuvant nivolumab with chemotherapy is recommended.