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Atezolizumab with carboplatin and etoposide for untreated extensive-stage small-cell lung cancer

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2 Information about atezolizumab with carboplatin and etoposide

Marketing authorisation indication

2.1 Atezolizumab (Tecentriq, Roche) with carboplatin (generic) and etoposide (generic) is indicated for 'the first-line treatment of adult patients with extensive-stage small-cell lung cancer (ES-SCLC)'.

Atezolizumab received a promising innovative medicine (PIM) designation in November 2018 and a positive opinion from the early access to medicines scheme (EAMS) in June 2019.

Dosage

2.2 Induction phase, every 3 weeks for 4 cycles:

  • atezolizumab: 1,200 mg, intravenously administered, day 1 of each cycle

  • carboplatin: (area under the curve 5 mg/ml/min), intravenously administered, day 1 of each cycle

  • etoposide: 100 mg/m2, intravenously administered, on days 1 to 3 of each cycle.

Maintenance phase after the induction phase, every 3 weeks until loss of clinical benefit or unmanageable toxicity:

  • atezolizumab monotherapy without chemotherapy, 1,200 mg administered intravenously on day 1 of each cycle.

Price

2.3 The list price of atezolizumab: £3,807.69 per 1,200 mg vial (excluding VAT; BNF online, assessed December 2019). The mean treatment cost of a course of treatment for a patient with ES‑SCLC is £32,798.39 for atezolizumab (at list price), £76.18 for carboplatin and £30.89 for etoposide.

The company has an existing commercial arrangement with the NHS. This makes atezolizumab available to the NHS with a discount and it would have also applied to this indication if the technology had been recommended. The size of the discount is commercial in confidence. It is the company's responsibility to let relevant NHS organisations know details of the discount.