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SHTAC is critically appraising the company’s submission to NICE on a nivolumab for treating relapsed or refractory lymphoma

Published: 17 November 2016
IV treatment
Around 1600 people in the UK are diagnosed with Hodgkin lymphoma each year.

SHTAC is assessing the company's evidence submission to the National Institute for Health and Care Excellence (NICE) on the clinical and cost effectiveness of nivolumab for treating relapsed or refractory classical Hodgkin lymphoma, as part of NICE’s Single Technology Appraisal process.

 

Hodgkin lymphoma, which most commonly affects people aged 20-24 and people aged over 75 years, is a cancer of the lymphatic system. The initial symptom of Hodgkin lymphoma is often the swelling of a lymph node in the neck, armpit or groin. Other symptoms include recurring fever, night sweats, weight loss, cough, breathlessness, abdominal pain and itching. Around 1600 people in the UK are diagnosed with Hodgkin lymphoma each year. There are two main groups of Hodgkin lymphoma; classical types (these contain Reed-Sternberg cells which are cancerous B lymphocyte cells) and the nodular lymphocyte predominant type (which contains abnormal cells but not Reed-Sternberg cells).

Chemotherapy or chemotherapy combined with radiotherapy is the current first-line treatment for Hodgkin lymphoma. However, a long-term remission is not achieved with first-line treatment for between 15 and 30% of people with Hodgkin lymphoma. If a long-term remission is not achieved a potentially curative treatment is high dose chemotherapy followed by autologous stem cell transplant but this is only effective in about 50% of people and it is not a treatment option for some people (e.g. when the disease is refractory to chemotherapy or due to the person’s age or co-morbidities). For people with relapsed or refractory Hodgkin lymphoma that expresses the antigen CD30 brentuximab vedotin is a treatment option.

Nivolumab (brand name ‘Opdivo’ ®, Bristol-Myers Squibb) is a new drug for people with relapsed or refractory classical Hodgkin lymphoma who have already received autologous stem cell transplant and drug treatment with brentuximab vedotin or who have received two prior therapies and for whom autologous stem cell transplant is not a treatment option. Nivolumab is an intravenously administered monoclonal antibody therapy that uses the body’s own immune system to attack cancer cells. Commonly referred to as cancer immunology, or immuno-oncology, this type of treatment is distinct to traditional chemotherapy which uses chemical substances to fight cancer cells. SHTAC is currently assessing the clinical effectiveness and cost effectiveness evidence submitted by the company to NICE for nivolumab for treating relapsed or refractory classical Hodgkin lymphoma. It is expected that NICE will issue guidance on the use of nivolumab for relapsed or refractory classical Hodgkin lymphoma in the NHS in July 2017.

For more information about SHTAC’s previous research into blood and bone marrow cancers please visit our Research page.

You can also find out more about the University of Southampton’s Centre for Cancer Immunology by visiting the ‘You’re It’ website.

 

 

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