Skip to main navigationSkip to main content
The University of Southampton
Southampton Health Technology Assessments CentreNews

Nivolumab for treating relapsed or refractory classical Hodgkin lymphoma is recommended by NICE

Published: 27 July 2017
Intravenous drip
Nivolumab is a new treatment for relapsed or refractory classical Hodgkin lymphoma

The National Institute for Health and Care Excellence (NICE) has issued guidance to the National Health Service on the use of the drug nivolumab for treating relapsed or refractory classical Hodgkin lymphoma, informed by a report produced by SHTAC.

There are approximately 2000 new cases of Hodgkin lymphoma in the UK each year and about 95% of these will be of the classical Hodgkin lymphoma subtype.  Most of people will achieve long-term remission following first-line treatment but approximately 15-30% of people do not achieve a long-term remission either because they do not respond to the first-line treatment (i.e. they have refractory disease) or because they relapse after initially responding to it.  People with relapsed or refractory classical Hodgkin lymphoma therefore require further treatment.  This is usually chemotherapy and/or radiotherapy delivered with the goal of achieving a sufficient response to allow autologous stem cell treatment (ASCT) to be carried out.  However, about 30% of patients who do not achieve long-term remission after first-line treatment are not eligible for ASCT (due to age or co-morbidities) and for the remaining 70% there would be an approximately 70-80% chance of achieving a sufficient remission for ASCT to take place.

When ASCT is undertaken it will be effective for about half the people who receive it.  Outcomes for those who relapse after ASCT have historically been very poor and people may be offered further chemotherapy (usually single-drug chemotherapy) including brentuximab vedotin, gemcitabine, bendamustine or cisplatin. If a good response to chemotherapy occurs allogeneic stem cell transplant is the treatment of choice.

Nivolumab [brand name: Opdivo®, Bristol-Myers Squibb (BMS)] is a new treatment for relapsed or refractory classical Hodgkin lymphoma, which is administered as an intravenous infusion every two weeks.  Nivolumab is a monoclonal antibody that acts as a programmed death-1 (PD-1) immune checkpoint inhibitor to promote an anti-tumour response.

NICE’s guidance recommends nivolumab within its marketing authorisation, as an option for treating relapsed or refractory classical Hodgkin lymphoma in adults after ASCT and treatment with brentuximab vedotin.  It is a condition of the guidance that BMS provides nivolumab with the discount agreed in the patient access scheme.

NICE’s guidance is informed by an evidence review group report prepared by SHTAC, which critically appraised the drug company’s submission to NICE’s Single Technology Appraisal process.

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


Privacy Settings