Durvalumab with tremelimumab can be used, within its marketing authorisation, as an option for untreated advanced or unresectable hepatocellular carcinoma (HCC) in adults. Durvalumab with tremelimumab can only be used if the company provides it according to the commercial arrangement.
What this means in practice
Durvalumab with tremelimumab must be funded in the NHS in England for the condition and population in the recommendation, if it is considered the most suitable treatment option. Durvalumab with tremelimumab must be funded in England within 90 days of final publication of this guidance.
There is enough evidence to show that durvalumab with tremelimumab provides benefits and value for money, so it can be used routinely across the NHS in this population.
NICE has produced tools and resources to support the implementation of this guidance.
Usual treatment for untreated advanced or unresectable HCC includes atezolizumab with bevacizumab, or lenvatinib or sorafenib alone. Most people have atezolizumab with bevacizumab.
Evidence from a clinical trial suggests that durvalumab with tremelimumab increases how long people live compared with sorafenib. Indirect comparisons suggest that durvalumab with tremelimumab is likely to work as well as atezolizumab with bevacizumab, and that is likely to increase how long people live compared with lenvatinib.
The most likely cost-effectiveness estimates are within the range that NICE normally considers an acceptable use of NHS resources compared with some of the usual treatments. So, durvalumab with tremelimumab can be used.