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Polatuzumab vedotin in combination for untreated diffuse large B-cell lymphoma [ID3901]

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1 Recommendations

1.1 Polatuzumab vedotin with rituximab, cyclophosphamide, doxorubicin and prednisolone (R-CHP) is not recommended, within its marketing authorisation, for untreated diffuse large B-cell lymphoma (DLBCL) in adults.

1.2 This recommendation is not intended to affect treatment with polatuzumab vedotin that was started in the NHS before this guidance was published. People having treatment outside this recommendation may continue without change to the funding arrangements in place for them before this guidance was published, until they and their NHS clinician consider it appropriate to stop.

Why the committee made these recommendations

Standard treatment for untreated DLBCL is rituximab, cyclophosphamide, doxorubicin, vincristine and prednisolone (R-CHOP).

Clinical evidence suggests that people having polatuzumab vedotin with R-CHP have more time before their cancer gets worse than people having R-CHOP alone. But there is not enough evidence to know if polatuzumab vedotin with R-CHP increases how long people live because the clinical trials would need to be done for much longer to find this out.

The cost-effectiveness estimates for polatuzumab vedotin with R-CHP are uncertain because there is not enough clinical evidence. They are also higher than what NICE usually considers an acceptable use of NHS resources. So, it is not recommended for routine use. Collecting more data would not resolve the uncertainties, so it is not recommended for use in the Cancer Drugs Fund.