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Southampton Health Technology Assessments CentreNews

Necitumumab for treating non-small-cell lung cancer (NSCLC) – NICE guidance now available

Published: 19 October 2016
Lung
Lung cancer is the second most common cancer diagnosed in the UK

The National Institute for Health and Care Excellence (NICE) has issued guidance to the health service on the use the drug necitumumab for locally advanced or metastatic squamous non-small-cell lung cancer (NSCLC) informed by a report produced by SHTAC.

 

Lung cancer is the second most common cancer diagnosed in the UK. It accounts for 13% of all new cancer cases in the UK and is the most common cause of death from cancer. Among lung cancer patients, around one in three patients will be diagnosed with squamous NSCLC. Other types of NSCLC include adenocarcinoma and large-cell carcinoma.

Current treatments for squamous NSCLC are used to delay cancer progression, to extend patients’ lives and to improve their symptoms and quality of life. These treatment options consist primarily of platinum-based chemotherapy regimens that include one of the drugs gemcitabine, paclitaxel, vinorelbine or docetaxel given in combination with either cisplatin or carboplatin. Necitumumab is a new drug for squamous NSCLC and it is given as an additional therapy to gemcitabine combined with cisplatin.

SHTAC produced a report to NICE critically appraising the evidence submitted by the company to NICE.  NICE’s guidance is that necitumumab in combination with gemcitabine and cisplatin, is not recommended for adults with locally advanced or metastatic epidermal growth factor receptor (EGFR)-expressing squamous NSCLC that has not been treated with chemotherapy.

The NICE Technology Appraisal Committee noted that necitumumab provides small but clinically important improvements in overall survival compared with gemcitabine plus cisplatin. However, the most plausible incremental cost-effectiveness ratio (ICER) for necitumumab compared with gemcitabine plus cisplatin was £110,000–£170,000 per quality-adjusted life year (QALY) gained, and was likely to be towards the upper end of this range. This is in excess of NICE’s threshold for cost-effectiveness of health technologies (£30,000 - £50,000 per QALY). It was also noted that whilst necitumumab is innovative, it does not meet the criteria to be considered a life-extending, end-of-life treatment. Necitumumab did not meet the criteria to be considered for inclusion in the Cancer Drugs Fund.

For more information on SHTAC’s previous research into lung cancer, please visit our Research page.

 

 

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