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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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1 Recommendations

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1 Recommendations

1.1

Pembrolizumab with carboplatin and paclitaxel should not be used for untreated primary advanced or recurrent endometrial cancer in adults.

1.2

This recommendation is not intended to affect treatment with pembrolizumab with carboplatin and paclitaxel 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

Pembrolizumab with carboplatin and paclitaxel is not required to be funded in the NHS in England for untreated primary advanced or recurrent endometrial cancer 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 pembrolizumab with carboplatin and paclitaxel offers value for money.

Why the committee made these recommendations

People with untreated advanced or recurrent endometrial cancer usually have platinum-based chemotherapy, such as the combination carboplatin and paclitaxel.

Clinical trial evidence shows that adding pembrolizumab to carboplatin and paclitaxel increases how long people have before their condition gets worse compared with carboplatin and paclitaxel alone. It is less certain how pembrolizumab with carboplatin and paclitaxel affects how long people live because the clinical trial has not been long enough and is still ongoing.

There are uncertainties in the economic model. This is because the model combined subgroups from the clinical trial to produce 1 larger population. But the clinical and cost effectiveness of pembrolizumab with carboplatin and paclitaxel are different in the 2 subgroups and they should be considered separately.

Because of the uncertainties, it is not possible to determine the most likely cost-effectiveness estimates for pembrolizumab with carboplatin and paclitaxel. So, it should not be used.

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