Avelumab not recommended as a maintenance treatment of urothelial cancer after platinum-based chemotherapy

NICE has today (06 May 2021) issued draft guidance which does not recommend avelumab for maintenance treatment of locally advanced or metastatic urothelial cancer after platinum-based chemotherapy.

Approximately 750 people with this type of urothelial cancer would have been eligible for avelumab as a maintenance treatment.

Evidence shows it took longer for people's cancer to get worse by taking avelumab, and they lived longer than if they had the best supportive care. However, the most likely cost-effectiveness estimates are significantly higher than NICE normally considers an acceptable use of NHS resources.

Because there are no planned or ongoing studies addressing the key uncertainties in the evidence provided, it was concluded that avelumab did not meet the criteria for inclusion in the Cancer Drugs Fund.

Meindert Boysen, deputy chief executive and director of the Centre for Health Technology Evaluation at NICE, said: "We know there are currently few, if any treatments available for people with this form of urothelial cancer, and that avelumab is a promising drug that has the potential to address this unmet clinical need. We are, therefore, committed to working with the company to help them address the issues identified by the committee that are highlighted in this draft guidance." 

Current treatments for people with locally advanced or metastatic urothelial cancer whose disease has progressed after platinum-containing chemotherapy include atezolizumab, docetaxel, paclitaxel or best supportive care.

The draft guidance is open for consultation until 27 May 2021

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