1 Recommendation
1.1
Trifluridine–tipiracil with bevacizumab is recommended, within its marketing authorisation, for treating metastatic colorectal cancer in adults who have had 2 lines of treatment (including fluoropyrimidine-, oxaliplatin- and irinotecan-based chemotherapies, antivascular endothelial growth factor or anti-epidermal growth factor receptor treatments). Trifluridine–tipiracil with bevacizumab is only recommended if the company provides trifluridine–tipiracil according to the commercial arrangement.
Why the committee made this recommendation
Standard treatment for metastatic colorectal cancer after 2 lines of treatment includes trifluridine–tipiracil alone or regorafenib.
The results of a clinical trial show that, compared with trifluridine–tipiracil alone, trifluridine–tipiracil plus bevacizumab increases how long people have before their cancer gets worse and how long they live. The results of an indirect comparison also suggest that trifluridine–tipiracil plus bevacizumab increases how long people have before their cancer gets worse and how long they live compared with regorafenib.
When considering the condition's severity, and its effect on quality and length of life, the most likely cost-effectiveness estimates are within the range that NICE normally considers an acceptable use of NHS resources. So, trifluridine–tipiracil plus bevacizumab is recommended.