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09-May-2019

New combination treatment for metastatic lung cancer patients approved for use on the NHS in England and Wales

2 May 2019, Welwyn Garden City – The National Institute for Health and Care Excellence (NICE) has recommended Tecentriq® (atezolizumab) in combination with Avastin® (bevacizumab), carboplatin and paclitaxel (chemotherapy) as an option for metastatic non-squamous non-small cell lung cancer (NSCLC) in adult patients who have not had treatment for their metastatic NSCLC before and whose PD-L1 expression is low or negative. The recommendation is also for those with EGFR or ALK-positive mutations, who have failed on a previous targeted therapy.[i] Available today, it is estimated around 4,800 patients with advanced NSCLC could benefit from this combination.[ii],[iii]

The decision is based on data which showed people treated with atezolizumab plus bevacizumab and chemotherapy lived longer versus those treated with bevacizumab plus chemotherapy.1

Over 46,000 new cases of lung cancer are diagnosed in the UK each year and around 87% of these cases are NSCLC.[iv],[v] Up to 15% of lung cancers are caused by EGFR or ALK-positive mutations as a result of gene alterations.[vi]

This decision by NICE is fantastic news for people living with metastatic NSCLC in England and Wales, where the current outlook is generally poor. For patients to have access to a life-extending treatment is an important step forward in order to advance outcomes in this area. Every additional day of life provides more opportunities to share time with their families, their friends and loved ones,” said Paula Chadwick, CEO of the Roy Castle Lung Cancer Foundation.

“This decision is an excellent example of the way NICE and industry work together to make clinically effective treatments available on the NHS.  The combination of chemotherapy with atezolizumab, which helps the body’s immune system to destroy cancer cells and bevacizumab, which blocks VEGF, a molecule which stops immune cells from functioning properly, has been shown to significantly improve progression-free survival and overall survival among patients with metastatic non-squamous NSCLC, compared to patients who received bevacizumab and chemotherapy alone. This was regardless of PD-L1 expression and EGFR or ALK genetic alteration status. Of note, the combination has been shown to be effective in NSCLC patients with either EGFR mutations or liver metastases, who typically have a poor prognosis, and could become a new standard of care for these two important patient subgroups,”  said Gary Middleton, Professor of Medical Oncology at the University of Birmingham.


[i] NICE (2019). Final appraisal document: Atezolizumab for treating metastatic non-squamous non-small-cell lung cancer. May 2019

[ii] Office for National Statistics. Population Estimates for UK, England and Wales, Scotland and Northern Ireland [Available from: https://www.ons.gov.uk/peoplepopulationandcommunity/populationandmigration/populationestimates/datasets/populationestimatesforukenglandandwalesscotlandandnorthernireland.

[iii] Royal College of Physicians. UK National Lung Cancer Audit 2018 [Available from: https://www.rcplondon.ac.uk/projects/national-lung-cancer-audit

[iv] Cancer Research UK. Lung Cancer Statistics. Available at: http://www.cancerresearchuk.org/health-professional/cancer-statistics/statistics-by-cancer-type/lung-cancer#heading-One [Last accessed: May 2019]

[v] Cancer Research UK. Lung cancer stages, types and grades. Available at: www.cancerresearchuk.org/about-cancer/lung-cancer/stages-types-grades/types [Last accessed: May 2019]

[vi] EGFR and ALK - About targeted cancer drugs - Advanced lung cancer treatment. Cancer Research UK. 2017 [Last accessed: May 2019]

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Last Updated: 09-May-2019