Pembrolizumab with platinum- and fluoropyrimidine-based chemotherapy for untreated advanced oesophageal and gastro-oesophageal junction cancer

  • Technology appraisal guidance
  • TA737
  • Published: 
  • Last updated: 
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1 Recommendations

1.1

Pembrolizumab with platinum- and fluoropyrimidine-based chemotherapy is recommended, within its marketing authorisation, as an option for untreated locally advanced unresectable or metastatic carcinoma of the oesophagus in adults whose tumours express PD‑L1 with a combined positive score (CPS) of 10 or more. Pembrolizumab is only recommended if the company provides it according to the commercial arrangement.

The recommendation for HER2‑negative gastro-oesophageal junction adenocarcinoma has been updated and replaced by NICE technology appraisal guidance on pembrolizumab with platinum- and fluoropyrimidine-based chemotherapy for untreated advanced HER2-negative gastric or gastro-oesophageal junction adenocarcinoma.

Why the committee made these recommendations

Treatment for advanced oesophageal cancer or HER2‑negative gastro-oesophageal junction adenocarcinoma includes platinum- and fluoropyrimidine-based chemotherapy. Clinical trial evidence shows that for people whose tumours express PD‑L1 with a CPS of 10 or more, adding pembrolizumab increases how long they live. It also increases the time before their disease gets worse.

Pembrolizumab meets NICE's criteria to be considered a life-extending treatment at the end of life. The cost-effectiveness estimates are likely to be within what NICE considers an acceptable use of NHS resources. Therefore, it is recommended.