NICE recommends against Opdivo for classical Hodgkin lymphoma

The National Institute of Health and Care Excellence (NICE) has released draft guidance provisionally turning down Bristol-Myers Squibb’s Opdivo (nivolumab) for the treatment of classical Hodgkin lymphoma (cHL) in patients whose disease is progressing despite prior treatment with brentuximab vedotin and autologous stem cell transplantation (ASCT).

In a Phase 2 study, Opdivo demonstrated "considerable cancer reduction" according to the company, with two-thirds of participants showing objective response rate, and a further 8% of these patients experiencing complete response with no remnants of cancer.

Despite these findings, the drug could not be deemed a worthwhile use of NHS resources, meaning patients could lose out the treatment against the blood cancer indication. BMS General Manager, UK and Ireland, Benjamin Hickey expressed frustration at the ruling in a statement:

"We are disappointed that NICE has not recommended nivolumab for the treatment of patients with this rare and aggressive form of blood cancer, in its preliminary guidance. This comes despite nivolumab being the first immunotherapy licensed and shown to improve survival in cHL patients who’ve tried all alternative options. We remain committed to finding a solution for patients and their families, and will be working with NICE to assess how we can reverse this decision and provide patients with access."

As a terminal illness in its advanced form, there are currently few treatment options for cHL, which accounts for around 95% of all Hodgkin lymphoma cases. BMS has argued the value of Opdivo in this indication by stating that clinical trial data shows that 95% of those suffering from the disease survive for at least one year when treated with the drug.

Matt Fellows