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1 Recommendations

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1 Recommendations

1.1

Amivantamab plus lazertinib should not be used for untreated advanced non-small-cell lung cancer (NSCLC) in adults whose tumours have epidermal growth factor receptor (EGFR) exon 19 deletions or exon 21 L858R substitution mutations.

1.2

This recommendation is not intended to affect treatment with amivantamab plus lazertinib that was started in the NHS before this guidance was published. People having treatment outside this recommendation may continue without change to the funding arrangements in place for them before this guidance was published, until they and their NHS healthcare professional consider it appropriate to stop.

What this means in practice

Amivantamab plus lazertinib is not required to be funded in the NHS in England to treat NSCLC in adults whose tumours have EGFR exon 19 deletions or exon 21 L858R substitution mutations. It should not be used routinely in the NHS in England.

This is because there is not enough evidence to determine whether amivantamab plus lazertinib is value for money in this population.

Why the committee made these recommendations

Usual treatment for NSCLC with EGFR exon 19 deletions or exon 21 L858R substitution mutations is osimertinib alone or osimertinib plus pemetrexed and platinum-based chemotherapy (from now, osimertinib plus chemotherapy).

Clinical trial evidence shows that amivantamab plus lazertinib increases how long people have before their condition gets worse and how long people live compared with osimertinib alone. But it is uncertain whether amivantamab plus lazertinib works as well for people of different ages.

It is also uncertain how well amivantamab plus lazertinib works compared with osimertinib plus chemotherapy because these treatments have not been compared.

There are uncertainties with some of the assumptions in the economic model comparing amivantamab plus lazertinib with osimertinib alone, including:

  • how long people live

  • how long people continue treatment

  • how each treatment affects quality of life.

Also, osimertinib plus chemotherapy has not been included as a comparator.

Because of the uncertainties in the economic model, it is not possible to determine the most likely cost-effectiveness estimates for amivantamab plus lazertinib. So, it should not be used.