540 adults will have access to Dostarlimab (also called Jemperli and made by GSK). Dostarlimab is a monoclonal antibody and helps the immune system to fight cancer. It is given through a drip over 30 minutes in hospital.
Clinical trial evidence shows that with platinum-based chemotherapy it improves life expectancy and extends the time before the cancer gets worse. But because the study only collected data for a short time, the long-term benefits are uncertain. Dostarlimab has therefore been recommended for use in the Cancer Drugs Fund (CDF). This means that it will be available in the NHS to treat this type of womb cancer while further evidence is collected.
There are 2 main types of womb cancer (endometrial cancer or uterine sarcoma) and around 9,000 new diagnoses annually in the UK. Endometrial cancer is the most common type of womb cancer, and around 23% of endometrial cancers are a subtype with high microsatellite instability or mismatch repair deficiency. Dostarlimab is recommended for these subtypes where the cancer is advanced or has come back following previous treatment.
Advanced or recurrent endometrial cancer (meaning that the cancer has spread beyond the uterus or come back after previous treatment) has a significant effect on both life expectancy and quality of life. This will be the fourth treatment option for endometrial cancer that NICE has recommended for either routine NHS commissioning or use through the CDF since NICE was founded in 1999.
Helen Knight, director of medicines evaluation said: “Advanced or recurrent womb cancer has a devastating effect on quality of life and there are limited treatment options available.
“We are focused on delivering what matters most and getting care to those who need it fast, so I am delighted this treatment option will be made quickly available through the CDF, enabling people with this type of cancer to enjoy more precious time with their families and loved ones.”
About the guidance:
- Final draft guidance - Project documents | Dostarlimab with platinum-based chemotherapy for treating advanced or recurrent endometrial cancer with high microsatellite instability or mismatch repair deficiency [ID3968] | Guidance | NICE
- Dostarlimab (Jemperli) was authorised through Project Orbis in October 2023. This is a global partnership between the MHRA, the Therapeutics Goods Administration in Australia, Health Canada, the Health Sciences Authority in Singapore, Swissmedic, Agência Nacional de Vigilância Sanitária in Brazil and Israel’s Ministry of Health, coordinated by the US Food and Drug Administration. This programme reviews and approves promising cancer drugs, helping patients to access treatments more quickly.
- NICE has already recommended dostarlimab for previously treated advanced or recurrent endometrial cancer with high microsatellite instability or mismatch repair deficiency (see TA779). This appraisal moves dostarlimab to an earlier line of therapy, so instead of being given following disease progression on chemotherapy, dostarlimab could be given in combination with chemotherapy.
- Treatments already recommended by NICE include:
- Pembrolizumab with lenvatinib for previously treated advanced or recurrent endometrial cancer.Overview | Pembrolizumab with lenvatinib for previously treated advanced or recurrent endometrial cancer | Guidance | NICE
- Pembrolizumab for previously treated endometrial, biliary, colorectal, gastric or small intestine cancer with high microsatellite instability or mismatch repair deficiency. Overview | Pembrolizumab for previously treated endometrial, biliary, colorectal, gastric or small intestine cancer with high microsatellite instability or mismatch repair deficiency | Guidance | NICE
- Dostarlimab for previously treated advanced or recurrent endometrial cancer with high microsatellite instability or mismatch repair deficiency. Overview | Dostarlimab for previously treated advanced or recurrent endometrial cancer with high microsatellite instability or mismatch repair deficiency | Guidance | NICE