1 Recommendations
1.1
Pembrolizumab is recommended as an option for treating relapsed or refractory classical Hodgkin lymphoma in people 3 years and over who have had at least 2 previous treatments and cannot have an autologous stem cell transplant (ASCT). It is recommended only if:
-
they have already had brentuximab vedotin and
-
pembrolizumab is stopped after 2 years of treatment or earlier if the person has a stem cell transplant or the disease progresses and
-
the company provides it according to the commercial arrangement.
Why the committee made these recommendations
This evaluation reviews the evidence for pembrolizumab for treating relapsed or refractory classical Hodgkin lymphoma in people who have had brentuximab vedotin and cannot have an ASCT (NICE technology appraisal guidance TA540). It also reviews new data collected as part of the managed access agreement. The new evidence includes data from clinical trials and from people having treatment in the NHS in England.
When people with relapsed or refractory classical Hodgkin lymphoma cannot have an ASCT, they can have brentuximab vedotin. After that, they have standard care, which includes chemotherapy and radiotherapy. Pembrolizumab would be offered instead of standard care and stopped after 2 years or earlier if the person's condition gets worse or they are able to have a stem cell transplant. This is in line with how people had pembrolizumab in the clinical trials and during the managed access period.
There is no evidence directly comparing pembrolizumab with standard care. But, indirect comparisons suggest that people who have pembrolizumab live longer.
When considering the condition's severity, and its effect on quality and length of life, the most likely cost-effectiveness estimates are within what NICE considers an acceptable use of NHS resources. So, pembrolizumab is recommended.