3.1 The appraisal committee (section 6) considered comments on the second appraisal consultation document, petitions, new evidence submitted by Bristol–Myers Squibb, a review of this submission by the evidence review group and a report from the NICE Decision Support Unit. After this meeting, production of the final appraisal determination was paused for Bristol–Myers Squibb and NHS England to have commercial discussions. Further new evidence submitted by Bristol–Myers Squibb was reviewed by the NICE Decision Support Unit and considered by the committee at the fifth meeting. See the committee papers for full details of the evidence.
3.2 Sections 4.1 to 4.27 reflect the committee's discussion of the evidence submitted for the first to fourth appraisal committee meetings. Section 4.28 (Cancer Drugs Fund) onwards reflects the committee's most recent discussion of the new evidence (clinical- and cost-effectiveness subgroup analyses by PD‑L1 expression) and the commercial access agreement submitted for consideration in the Cancer Drugs Fund, and discussed at the fifth appraisal committee meeting. The committee's overall conclusions are described in sections 4.36 and 4.37.