Erdafitinib is recommended, within its marketing authorisation, as an option for treating unresectable or metastatic urothelial cancer with susceptible FGFR3 genetic alterations in adults after at least 1 line of treatment for unresectable or metastatic cancer that included a PD‑1 or PD‑L1 inhibitor. Erdafitinib is only recommended if the company provides it according to the commercial arrangement.
Why the committee made this recommendation
Usual treatment for unresectable or metastatic urothelial cancer with FGFR3 genetic alterations after at least 1 line of treatment that included a PD‑1 or PD‑L1 inhibitor is paclitaxel with or without carboplatin, or best supportive care.
Erdafitinib has not been directly compared in a clinical trial with paclitaxel with or without carboplatin, or best supportive care. But indirect comparisons with each of these comparators suggest that erdafitinib increases how long people have before their cancer gets worse and how long they live.
When considering the condition's severity, and its effect on quality and length of life, the most likely cost-effectiveness estimates are within the range that NICE considers an acceptable use of NHS resources. So, erdafitinib is recommended.