1.1 Dostarlimab is recommended for use within the Cancer Drugs Fund as an option for treating advanced or recurrent endometrial cancer with high microsatellite instability or mismatch repair deficiency in adults who have had platinum-based chemotherapy. It is recommended only if the conditions in the managed access agreement are followed.
1.2 This recommendation is not intended to affect treatment with dostarlimab 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 clinician consider it appropriate to stop.
Why the committee made these recommendations
There is no standard treatment for previously treated advanced or recurrent endometrial cancer with high microsatellite instability or mismatch repair deficiency. People are usually offered further chemotherapy, which has limited effectiveness, so there is an unmet need for an effective treatment for this population.
Clinical trial evidence suggests that dostarlimab increases the time until the cancer gets worse and how long people live. However, this is uncertain because the trial is ongoing and dostarlimab has not been directly compared with other treatment options. Indirect comparisons of dostarlimab with other treatments are highly uncertain because of differences between the included studies.
Dostarlimab has the potential to be cost effective, but more long-term evidence is needed to address the clinical uncertainties. So, dostarlimab cannot be recommended for routine use in the NHS.
More data from the dostarlimab trial would help address uncertainties about its clinical effectiveness. Dostarlimab is therefore recommended for use in the Cancer Drugs Fund so that more data can be collected.