1 Recommendations
1.1 Asciminib is recommended, within its marketing authorisation, as an option for treating chronic-phase Philadelphia chromosome-positive chronic myeloid leukaemia without a T315I mutation after 2 or more tyrosine kinase inhibitors in adults. It is recommended only if the company provides asciminib according to the commercial arrangement.
Why the committee made these recommendations
Usual treatment for chronic-phase Philadelphia chromosome-positive chronic myeloid leukaemia without a known T315I mutation after 2 or more tyrosine kinase inhibitors is tyrosine kinase inhibitors such as bosutinib, ponatinib, dasatinib or nilotinib. Although an allogeneic stem cell transplant can be a cure, it is not an option for many people. Asciminib is another tyrosine kinase inhibitor.
Clinical trial evidence shows that asciminib works better than bosutinib in people without a T315I mutation who have had 2 or more tyrosine kinase inhibitors, but it is uncertain how much longer people having asciminib live. It is unclear how well asciminib works compared with the other tyrosine kinase inhibitors when compared indirectly. This makes the clinical and cost-effectiveness results uncertain.
Despite the uncertainties, the cost-effectiveness estimates are likely to be within the range NICE considers an acceptable use of NHS resources. So, asciminib is recommended.