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    Has all of the relevant evidence been taken into account?

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    Are the summaries of clinical and cost effectiveness reasonable interpretations of the evidence?

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Draft guidance consultation

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1 Recommendations

1.1

Amivantamab with carboplatin and pemetrexed should not be used for untreated advanced non-small cell lung cancer (NSCLC) with activating EGFR exon 20 insertion (ex20ins) mutations in adults.

1.2

This recommendation is not intended to affect treatment with amivantamab with carboplatin and pemetrexed 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 healthcare professional consider it appropriate to stop.

What this means in practice

Amivantamab with carboplatin and pemetrexed is not required to be funded in the NHS in England for untreated advanced ex20ins mutation-positive NSCLC in adults. It should not be used routinely in the NHS in England.

This is because there is not enough evidence available to determine if amivantamab with carboplatin and pemetrexed offers value for money.

Why the committee made these recommendations

Usual treatment for untreated advanced NSCLC with ex20ins mutations includes carboplatin with pemetrexed or best supportive care.

Clinical trial evidence shows that amivantamab with carboplatin and pemetrexed increases how long people have before their condition gets worse compared with just carboplatin and pemetrexed. But the effect of amivantamab with carboplatin and pemetrexed on how long people live is uncertain because there is limited clinical trial evidence.

There are uncertainties in the economic evidence, including the method used to estimate how long people live. Because of this, it was not possible to determine the most likely cost-effectiveness estimates. So, amivantamab with carboplatin and pemetrexed should not be used.

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