Cemiplimab can be used as an option to treat recurrent or metastatic cervical cancer that has progressed on or after platinum-based chemotherapy in adults if:
they have not had immunotherapy
treatment is stopped after 32 cycles (each lasting 3 weeks), or earlier if the cancer progresses or there is unacceptable toxicity, and
the company provides cemiplimab according to the commercial arrangement.
This recommendation is not intended to affect treatment with cemiplimab that was started in the NHS before this guidance was published. People having treatment outside this recommendation may continue without change to the funding arrangements in place for them before this guidance was published, until they and their NHS healthcare professional consider it appropriate to stop.
Cemiplimab must be funded in the NHS in England for the condition and population in the recommendations, if it is considered the most suitable treatment option. Early funding for cemiplimab is available through the Cancer Drugs Fund from the point of marketing authorisation or release of positive draft guidance, whichever is later. Funding is available until 90 days after final publication of this guidance. After that, cemiplimab must be funded through routine commissioning in England.
There is enough evidence to show that cemiplimab provides benefits and value for money, so it can be used routinely across the NHS in this population.
NICE has produced tools and resources to support the implementation of this guidance.
Usual treatment for recurrent or metastatic cervical cancer that has progressed on or after platinum-based chemotherapy (with or without immunotherapy) is single-agent chemotherapy.
Cemiplimab is licensed for people who have had platinum-based chemotherapy. This includes people who also had immunotherapy. But, for this evaluation, the company asked for cemiplimab to be considered only for people who have not had immunotherapy.
Clinical trial evidence shows that cemiplimab increases how long people have before their cancer gets worse, and how long they live, compared with single-agent chemotherapy. In this trial, people could have cemiplimab for up to 32 cycles (each lasting 3 weeks).
When considering the condition's severity, and its effect on quality and length of life, the most likely cost-effectiveness estimates are within the range that NICE considers an acceptable use of NHS resources. So, cemiplimab can be used.