NICE has published a draft final assessment document (FAD) recommending Durvalumab (Imfinzi, AstraZeneca) as an option for the treatment of non-small cell lung cancer (NSCLC) in adults.
More than 400 people in England with locally advanced unresectable NSCLC, whose tumors express PD-L1 on 1% or more of cells and whose disease has not progressed after concurrent platinum-based chemoradiotherapy, could receive immunotherapy treatment.
NICE recommends durvalumab for routine use on the NHS after clinical evidence shows it increases patient survival time and the time it takes for cancer to progress.
Durvalumab is a PD-L1 inhibitor; it helps the body’s immune system find and attack cancer cells, by blocking the PD-L1 protein that disguises cancer.
NICE considered additional evidence gathered while durvalumab was available as a use option within the Cancer Drugs Fund (CDF), which addressed clinical uncertainties identified in the initial assessment, before recommending the treatment for use in routine on the NHS.
The Technology Review Board noted that treatment options for people with locally advanced unresectable NSCLC are limited and that clinical evidence has shown that durvalumab prolongs progression-free survival. A review of five years of data found that the median progression-free survival was just over two years for people with unresectable locally advanced NSCLC who had had at least 2 cycles of concurrent chemoradiation and were taking durvalumab , compared to five and a half months for those receiving standard care.
Clinical evidence has also shown that durvalumab increases overall survival compared to standard care. Median overall survival for people with locally advanced unresectable NSCLC who had had at least 2 cycles of concurrent chemoradiation and were taking durvalumab was just over 5 years, compared with just under two and a half years for those receiving standard care.
Durvalumab is given as an intravenous infusion every four weeks until disease progression, unacceptable toxicity, or for up to 12 months.
A confidential discounted patient access scheme has been agreed between NHS England and NHS Improvement and the company.
The draft final evaluation document (FAD) for durvalumab is available on the NICE website.