Pembrolizumab with chemoradiotherapy (external beam radiation therapy followed by brachytherapy) can be used, within its marketing authorisation, as an option for untreated International Federation of Gynecology and Obstetrics (FIGO) 2014 stages 3 to 4A locally advanced cervical cancer in adults. Pembrolizumab can only be used if the company provides it according to the commercial arrangement.
Pembrolizumab with chemotherapy must be funded in the NHS in England for the condition and population in the recommendation, if it is considered the most suitable treatment option. It must be funded in England within 90 days of final publication of this guidance.
There is enough evidence to show that pembrolizumab with chemoradiotherapy 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 FIGO 2014 stages 3 to 4A locally advanced cervical cancer is chemoradiotherapy.
Clinical trial evidence shows that pembrolizumab with chemoradiotherapy increases how long people have before their cancer gets worse and how long they live compared with chemoradiotherapy alone.
Despite uncertainties in the economic model, the cost-effectiveness estimates are within the range that NICE considers an acceptable use of NHS resources. So, pembrolizumab plus chemoradiotherapy can be used.