Avelumab for untreated metastatic Merkel cell carcinoma

1.1 Avelumab is recommended as an option for treating metastatic Merkel cell carcinoma in adults who have not had chemotherapy for metastatic disease. It is recommended only if the company provides avelumab according to the commercial arrangement.

Why the committee made this recommendation

This appraisal reviews the additional evidence collected in the Cancer Drugs Fund managed access agreement for avelumab for metastatic Merkel cell carcinoma in adults who have not had chemotherapy for metastatic disease (NICE technology appraisal guidance 517). The new evidence includes data from clinical trials and from people having treatment in the NHS while this treatment was available in the Cancer Drugs Fund in England.

Avelumab is routinely available in the NHS for treating metastatic Merkel cell carcinoma after chemotherapy. Evidence collected while avelumab was in the Cancer Drugs Fund shows that it is an effective treatment for untreated disease. It shows that, compared with chemotherapy, avelumab improves how long people have before their disease progresses and how long they live.

Avelumab is considered to be a life‑extending treatment at the end of life. Cost‑effectiveness estimates for avelumab are within what NICE consider an acceptable use of NHS resources. Therefore, it is recommended.