In new draft guidance, atezolizumab (also called Tecentriq and made by Roche) with carboplatin and etoposide has been recommended as an option for untreated extensive-stage small-cell lung cancer (ES-SCLC).
Around 2400 people in England have ES-SCLC, of whom around 1200 people will be eligible for treatment with atezolizumab with carboplatin and etoposide.
The positive recommendation follows consultation on NICE’s previous draft guidance which did not recommend the treatment. The company has since agreed on a new price for atezolizumab with NHS England and Improvement, which means that the treatment is now considered a cost-effective use of NHS resources.
The clinical trial evidence for the combination treatment was based on patients with an Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1. Clinical experts suggested that the effects of the treatment may be different for people with a score of 2 or higher, that is, a more severe illness, so atezolizumab with carboplatin and etoposide was recommended only for patients with an ECOG performance status of 0 or 1.
Meindert Boysen, deputy chief executive officer and director of the Centre for Health Technology Evaluation at NICE, said: “We are pleased to be able to recommend this new treatment that could extend the life of patients with this type of lung cancer.
“I know how important this news will be for patients suffering with this condition, for which there are currently few treatment options. Atezolizumab with carboplatin and etoposide may offer valuable time for patients to spend with their loved ones.”
ES-SCLC is a form of lung cancer accounting for 1 in 8 lung cancer cases in the UK. It is an aggressive disease that progresses rapidly, with a significant negative impact on the quality of life of patients.
Clinical trial evidence suggests that atezolizumab with carboplatin and etoposide increases the time before the disease worsens by around 1 month compared with standard chemotherapy (5.2 months versus 4.3 months respectively).
It also suggests that atezolizumab plus carboplatin and etoposide increases overall survival compared with standard chemotherapy. However, the long-term benefit on overall survival was uncertain.
NICE expects to publish its final guidance on atezolizumab for ES-SCLC in June 2020.