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Southampton Health Technology Assessments CentreNews

Treatment of urothelial carcinoma - SHTAC is assessing the company’s evidence submission to NICE on new drug atezolizumab

Published: 31 January 2017
Patient receiving chemotherapy
Urothelial cancer most commonly affects the bladder

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 atezolizumab for treating locally advanced or metastatic urothelial carcinoma, as part of NICE’s Single Technology Appraisal process.


Urothelial carcinoma is a cancer that affects the transitional cells of the urinary system including the bladder, urethra, ureter and renal pelvis. It occurs most commonly in people aged over 60 years, and smoking is a major risk factor. The most frequent symptom of bladder cancer is blood in the urine. Other symptoms include the frequent need and sudden urge to urinate, a burning sensation while urinating, pain in the bone and pelvic region, weight loss, and swelling of the legs. While transitional cell carcinoma (TCC) of the renal pelvis, ureter and urethra are rare in the UK, TCC of the bladder is the most common type of bladder cancer and affects around 10,000 people every year, which makes it the seventh most common cancer in the UK.

The current treatment options for patients with metastatic or advanced urothelial cancer include surgery and/or radiotherapy. Chemotherapy may be given before or after surgery, or radiotherapy, and may also be given in patients with urothelial cancer which is too advanced for surgery or radiotherapy, or in those for whom the condition has recurred after other treatments. Atezolizumab (brand name Tecentriq®, Roche) is from a class of drugs known as immunotherapy (specifically, it is an anti-programmed cell death ligand-1 (PD-L1) monoclonal antibody) which aims to suppress cancer by modifying the patient’s immune response and T-cell activity. The drug is administered intravenously.

SHTAC is assessing the clinical and cost-effectiveness evidence submitted by Roche to NICE for atezolizumab as a treatment option for locally advanced or metastatic urothelial carcinoma in patients whose cancer has spread after previous chemotherapy or who are unsuitable for cisplatin-based chemotherapy. It is expected that NICE will issue guidance on the use of atezolizumab for urothelial carcinoma in the NHS in September 2017. For more information about SHTAC’s previous research into urothelial cancers, please visit our Research page. 


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