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1 Recommendations

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1 Recommendations

1.1

Dostarlimab plus platinum-containing chemotherapy should not be used to treat primary advanced or recurrent endometrial cancer with microsatellite stability (MSS) or mismatch repair proficiency (MMRp) in adults when systemic treatment is suitable.

1.2

This recommendation is not intended to affect treatment with dostarlimab plus platinum-containing chemotherapy 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

Dostarlimab plus platinum-containing chemotherapy is not required to be funded in the NHS in England to treat primary advanced or recurrent endometrial cancer with MSS or MMRp in adults when systemic treatment is suitable. It should not be used routinely in the NHS in England for this indication.

This is because there is not enough evidence to determine whether dostarlimab plus platinum-containing chemotherapy offers value for money in this population.

Why the committee made these recommendations

Usual treatment for primary advanced or recurrent endometrial cancer with MSS or MMRp is platinum-containing chemotherapy (for example, carboplatin and paclitaxel).

Evidence collected up to September 2022 from an ongoing clinical trial suggests that dostarlimab plus carboplatin and paclitaxel may increase the time before a person's cancer gets worse more than placebo plus carboplatin and paclitaxel. But this is uncertain taking into account later evidence collected up to September 2023. It is also unclear whether adding dostarlimab to usual treatment increases how long people live.

There are also uncertainties in the economic model related to modelling of:

  • how long people live before their condition gets worse

  • the use of treatments after the condition progresses

  • the related impact on how long people live and how long treatment effects may last.

Because of the uncertainties in the clinical-effectiveness evidence and economic model, it is not possible to determine the most likely cost-effectiveness estimates for dostarlimab plus platinum-containing chemotherapy. So, it should not be.