An innovative new drug for treating advanced or recurrent endometrial cancer in adults who have had platinum-based chemotherapy is being recommended by NICE as an option for use within the Cancer Drugs Fund.
NICE has published its final appraisal document on dostarlimab, an immunotherapy treatment which could benefit 124 people a year in England as a second-line treatment for endometrial cancer with high microsatellite instability or mismatch repair deficiency. Endometrial cancer (EC) is a type of uterine cancer originating in the lining of the womb. Endometrioid carcinoma is the most common subtype, resulting in an estimated 2,162 deaths every year in the UK.
In normal cells, the body’s mismatch repair (MMR) system recognises and repairs genetic mismatches. However, 26% of endometrial tumours have a defect in the MMR system, meaning unstable and dysfunctional DNA is not addressed.
There are currently a range of different treatment options available to people with advanced or recurrent endometrial cancer after having platinum-based chemotherapy. However, there are no standard second-line treatments, and the options provide limited survival benefit. Therefore, the prognosis for patients is poor. Standard chemotherapy can take up to a day to be administered in hospital, but a dostarlimab infusion takes around 30 minutes.
Helen Knight, programme director in the Centre for Health Technology Evaluation at NICE, said: “We are committed to helping to provide early access for patients to promising new treatments, such as dostarlimab. Our committee concluded that people with previously treated advanced or recurrent endometrial cancer need new options and the overall evidence suggests that this treatment is more effective than current care so could offer a considerable improvement in quality of life.
“This is a significant development because dostarlimab provides, for the first time, a targeted immunotherapy treatment for people with the mismatch repair deficiency biomarker. Previously there were no targeted treatments licensed for this condition. While dostarlimab cannot be recommended for routine use in the NHS at this stage it is being recommended for use in the Cancer Drugs Fund so that more comparative data and long-term evidence can be collected to address clinical uncertainties.” A confidential price discount has been provided to the NHS.
