Technical / NICE: Lung cancer treatment available through CDF

NICE has recommended pembrolizumab for use within the Cancer Drugs Fund as an option for treating untreated PD-L1-positive metastatic non-small-cell lung cancer. Technology appraisal TA447 sets out the criteria that need to be met.

There are currently limited treatment options for people with this condition and what treatments there are can last a long time and cause unpleasant side effects.

Pembrolizumab will be available to the NHS in line with the conditions of the managed access agreement with NHS England. As part of this, NHS England and the drug’s manufacturer Merck, Sharp & Dohme have a commercial access agreement that makes pembrolizumab available to the NHS at a reduced cost. The financial terms of the agreement are commercial in confidence.

Pembrolizumab acts on the PD-1 protein, which is part of the immune checkpoint pathway. Blocking its activity may promote an anti-tumour immune response. It is seen as appropriate treatment if the patient’s tumours express PD-L1 with at least a 50% tumour proportion score with no epidermal growth factor receptor or anaplastic lymphoma kinase-positive tumour mutations. 

Treatment is stopped at two years of uninterrupted treatment and no documented disease progression.

The resource impact of pembrolizumab will be covered by the Cancer Drugs Fund budget. The guidance on this technology will be considered for review when the data collection period ends. This is anticipated to be December 2017, when the results of the Keynote-024 trial are available. The aim of the review is to decide whether the drug can be recommended for routine use. More details can be found on NHS England website.

It is estimated that around 1,500 people per year with untreated PD-L1-positive metastatic non-small-cell lung cancer are eligible for treatment with pembrolizumab.

This technology is commissioned by NHS England. Providers are NHS hospital trusts.