1 Recommendations
1.1 Nivolumab is recommended as an option for treating recurrent or metastatic squamous cell carcinoma of the head and neck in adults whose disease has progressed on platinum‑based chemotherapy, only if:
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the disease has progressed within 6 months of having chemotherapy and
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the company provides it according to the commercial arrangement.
Why the committee made these recommendations
This appraisal reviews the additional evidence collected as part of the Cancer Drugs Fund managed access agreement for nivolumab for treating recurrent or metastatic squamous cell carcinoma of the head and neck after platinum‑based chemotherapy.
The new evidence includes data from 1 clinical trial and from people having treatment in the NHS, while this treatment was available in the Cancer Drugs Fund in England. The new evidence shows that people who have nivolumab are likely to live up to 9 months longer than those who have other treatments. But it is unclear how well nivolumab works compared with docetaxel, which is the most relevant comparator.
Nivolumab meets NICE's criteria to be considered a life-extending treatment at the end of life. Despite the uncertainty in the clinical evidence, the cost-effectiveness estimates are likely to be within the range NICE considers an acceptable use of NHS resources. So, nivolumab is recommended.