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New HTA Decisions in England
June 2020
Drug name
TECENTRIQ® (atezolizumab)
Company
Roche
Decision date
22/05/2020
Therapeutic area
Cancer
Therapeutic sub area
Breast cancer
Decision
Recommended
Indication
In combination with nab‑paclitaxel for treatment of triple-negative, unresectable, locally advanced or metastatic breast cancer in adults whose tumours express PD‑L1 at a level of 1% or more and who have not had previous chemotherapy for metastatic disease.
Decision Detail
There is a simple discount patient access scheme for atezolizumab.
Summary
Atezolizumab with nab‑paclitaxel is recommended. There are currently no targeted or immunotherapy treatments for triple-negative breast cancer. The only treatment option is chemotherapy, usually with taxane monotherapy. Atezolizumab is the first immunotherapy to be approved for PD‑L1‑positive, triple-negative advanced breast cancer. It is used in combination with the chemotherapy agent, nab‑paclitaxel. Clinical trial evidence shows that people having atezolizumab plus nab‑paclitaxel live longer before their condition gets worse than people having placebo plus nab‑paclitaxel. It also suggests that they live longer overall. There is no direct comparison of atezolizumab plus nab‑paclitaxel with taxanes that are used in the NHS, such as weekly paclitaxel. However, it is reasonable to assume that nab‑paclitaxel has a similar efficacy to weekly paclitaxel. Atezolizumab plus nab‑paclitaxel is considered to be a life-extending treatment at the end of life. The cost-effectiveness estimates are within what NICE considers an acceptable use of NHS resources.