1 Recommendations
1.1
Lisocabtagene maraleucel (liso‑cel) is recommended as an option for treating large B‑cell lymphoma that is refractory to, or has relapsed within 12 months after, first-line chemoimmunotherapy in adults with:
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diffuse large B‑cell lymphoma
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high-grade B‑cell lymphoma
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primary mediastinal large B-cell lymphoma, or
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follicular lymphoma grade 3B.
Liso-cel is recommended only if:
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an autologous stem cell transplant would be considered suitable, and
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the company provides it according to the commercial arrangement.
1.2
Healthcare professionals should not use a person's age as a proxy measure for fitness when determining whether an autologous stem cell transplant would be suitable.
Why the committee made these recommendations
For this evaluation, the company asked for liso‑cel to be considered only for people who can have an autologous stem cell transplant. This does not include everyone who it is licensed for. People can have a stem cell transplant if their healthcare professional thinks they are fit enough to have it.
Standard care for relapsed or refractory large B‑cell lymphoma after first-line chemoimmunotherapy when a stem cell transplant is suitable is salvage chemotherapy, high-dose chemotherapy and stem cell transplantation.
Clinical trial evidence shows that liso‑cel increases how long people have before they need another line of treatment, or their condition gets worse, compared with standard care. Evidence for how long people live after treatment with liso‑cel is uncertain.
There are uncertainties in the assumptions used in the economic model. But there are also some benefits of liso-cel that are not captured in the modelling. These include the potential for people to have liso-cel as an outpatient treatment. The cost-effectiveness estimates are within the range that NICE considers an acceptable use of NHS resources. So, liso‑cel is recommended.
Because age is a protected characteristic under the Equality Act 2010, it should not be used as a measure of fitness when deciding whether an autologous stem cell transplant is suitable.