1 Recommendations

1.1

Crizotinib is recommended as an option for treating ROS1-positive advanced non-small-cell lung cancer in adults, only if:

1.2

Use the least expensive option of the available treatments (including crizotinib and entrectinib). Take account of administration costs, dosages, price per dose and commercial arrangements. If the least expensive option is unsuitable, people with the condition and their healthcare professional should discuss the advantages and disadvantages of other treatments.

1.3

This recommendation is not intended to affect treatment with crizotinib 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.

Why the committee made these recommendations

This evaluation reviews the evidence for crizotinib for treating ROS1-positive advanced non-small-cell lung cancer (NICE technology appraisal guidance 529). It also reviews new data collected as part of the managed access agreement.

Usual treatment for ROS1-positive advanced non-small-cell lung cancer is entrectinib, which works in a similar way to crizotinib. Crizotinib and entrectinib will likely be offered to the same population.

There is limited clinical evidence for crizotinib and it has not been directly compared in a trial with entrectinib. But indirect comparisons suggest that crizotinib may work as well as entrectinib.

A cost comparison suggests crizotinib has lower costs than or similar costs to entrectinib. So crizotinib is recommended.

For all evidence see the committee papers. For more information on NICE's evaluation of entrectinib, see the committee discussion section in NICE's technology appraisal guidance on entrectinib for treating ROS1-positive advanced non-small-cell lung cancer.