1.1 Pembrolizumab plus lenvatinib is recommended, within its marketing authorisation, for treating advanced or recurrent endometrial cancer in adults:
whose cancer has progressed on or after platinum-based chemotherapy and
who cannot have curative surgery or radiotherapy.
Pembrolizumab plus lenvatinib is recommended only if the companies provide them according to the commercial arrangements.
Why the committee made these recommendations
There is no standard treatment for previously treated advanced or recurrent endometrial cancer. But people would usually have non-platinum-based chemotherapy.
Evidence from a clinical trial suggests that pembrolizumab plus lenvatinib increases the time until the cancer gets worse and how long people live compared with non-platinum-based chemotherapy. But, the results are uncertain because treatments not used in the NHS were used after non-platinum-based chemotherapy in the trial. So, the results may not apply to UK clinical practice.
Pembrolizumab plus lenvatinib meets NICE's criteria to be considered a life-extending treatment at the end of life. There is some uncertainty in the economic model about how long the effect of treatment lasts after people stop taking pembrolizumab at 2 years. But the cost-effectiveness estimates are within the range considered acceptable for an end of life treatment. So, pembrolizumab plus lenvatinib is recommended.