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New HTA Decisions in England
June 2020
Drug name
TECENTRIQ® (atezolizumab)
Company
Roche
Decision date
27/05/2020
Therapeutic area
Cancer
Therapeutic sub area
Lung cancer
Decision
Recommended with restrictions
Indication
In combination with carboplatin and etoposide for the treatment of extensive-stage small-cell lung cancer.
Decision Detail
Atezolizumab with carboplatin and etoposide is recommended as an option for untreated extensive-stage small-cell lung cancer in adults, only if: • Patients have an Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1, and • The company provides atezolizumab according to the commercial arrangement. When using ECOG performance status, healthcare professionals should take into account any physical, sensory or learning disabilities, or communication difficulties that could affect ECOG performance status and make any adjustments they consider appropriate. There is a simple discount patient access scheme for atezolizumab.
Summary
People with extensive-stage small-cell lung cancer have carboplatin and etoposide chemotherapy as their first treatment. Clinical trial evidence is in people with an ECOG status of 0 or 1 (that is, they are more able to do daily tasks and ordinary activities than those with poorer ECOG status). It suggests that atezolizumab with chemotherapy could help people to live longer without their disease progressing, and to live for longer compared with chemotherapy alone. Atezolizumab meets NICE's criteria to be considered a life-extending treatment at the end of life. The cost-effectiveness estimates comparing atezolizumab and chemotherapy with chemotherapy alone are uncertain, but they are within what NICE normally considers an acceptable use of NHS resources. Because the clinical evidence is for people with an ECOG status of 0 or 1, atezolizumab with carboplatin and etoposide is only recommended for this group.