NICE no for BMS’ Opdivo for head and neck cancer

The UK’s National Institute for Health and Care Excellence (NICE) has turned down Bristol Myers Squibb’s (BMS) immunotherapy Opdivo (nivolumab) for recurrent or metastatic squamous cell carcinoma of the head and neck (SCCHN) after platinum-based chemotherapy.

In draft guidance, NICE said evidence collected in the clinical trial and through its own Cancer Drugs Fund  (CDF) showed that people with SCCHN live longer when treated with Opdivo than with one of three possible treatments in the comparator arm.

However, the cost-effectiveness agency added that there was uncertainty around these results, as one of the comparator treatments – docetaxel – is used as a standard of treatment for these patients in the NHS.

This cast doubt on the long-term, overall survival benefit of Opdivo, NICE said in a statement. The cost-effectiveness estimates were also higher than what NICE considers an ‘acceptable’ use of NHS resources, the agency added.

Although checkpoint inhibitor is currently available through the Cancer Drugs Fund (CDF), if the final guidance does not change the initial recommendation, the treatment will be removed from the CDF.

This means that new patients will not be able to access Opdivo through the CDF, with patients already receiving the therapy remaining unaffected for up to two years after starting treatment.

In September 2020, NICE recommended Opdivo as a second-line treatment option for patients with squamous non-small cell lung cancer (NSCLC).

Opdivo belongs to a class of treatments known as checkpoint inhibitors – Opdivo blocks a protein known as PD-L1, which inhibits the immune system’s ability to recognise and attack cancer cells.

By blocking this protein, Opdivo helps the immune system to identify and kill cancer cells on its own.