NICE recommends Tecentriq for first-line NSCLC

The UK National Institute for Health and Care Excellence (NICE) has recommended Roche’s Tecentriq (atezolizumab) monotherapy for untreated metastatic non-small cell lung cancer (NSCLC).

Tecentriq (atezolizumab) is indicated for adults with metastatic NSCLC if their tumours have PD-L1 expression on at least 50% of tumour cells or 10% of tumour-infiltrating immune cells.

The immunotherapy can also only be administered if a patient’s tumours do not have epidermal growth factor receptor (EGFR) or anaplastic lymphoma-infiltrating immune cells.

In the IMpower110 study, Tecentriq was found to improve overall survival for metastatic NSCLC patients compared to chemotherapy – 20.2 months versus 13.1 months, respectively.

In addition, the immunotherapy also improved progression-free survival compared to chemotherapy – 8.1 months compared with 5.0 months.

Although there is no evidence directly comparing Tecentriq with MSD’s Keytruda (pembrolizumab), Roche carried out an indirect comparison, which included data from IMpower110 and two studies comparing Keytruda with chemotherapy – KEYNOTE-024 and KEYNOTE-042.

Results from this indirect comparison suggest that Tecentriq is as effective as Keytruda in delaying disease progression and in extending life, although NICE added that this is uncertain as it is not a direct evidence.

“Despite the uncertainty in the indirect comparison, the most likely cost-effectiveness estimates for [Tecentriq] are within what NICE considers an acceptable use of NHS resources. So [Tecentriq] is recommended,” NICE said in the guidance.

“After working closely with the lung cancer community and NICE, we are now able to offer eligible patients with NSCLC in England, Wales and Northern Ireland a chemotherapy-free treatment option that has been shown to improve overall survival compared to platinum-based chemotherapy alone and which patients can continue to receive until their disease progresses, which can be longer than two years if appropriate,” said Gemma Boni, head of lung cancer, Roche Products Limited.