10th January 2020

‘Deeply disappointing’ – our reaction as NICE rejects combination therapy for Small Cell Lung Cancer

View all Treatment

The National Institute for Health and Care Excellence (NICE) has decided against approving a combination of immunotherapy and chemotherapy to treat some adults with small cell lung cancer.

Our chief executive, Paula Chadwick, described the ruling as “as a deeply disappointing decision”. 

The new treatment combined the immunotherapy drug atezolizumab with standard chemotherapy drugs carboplatin and etoposide.

This combination treatment would have represented a fresh treatment option for adults with untreated extensive stage small cell lung cancer, which is when the cancer has spread beyond a single area and that can’t be treated with radiotherapy.

Adding the immunotherapy drug atezolizumab (which goes by the trade name ‘Tecentriq’) to standard chemotherapy drugs has been shown to give patients more time before their cancer gets bigger and can improve survival.

However, NICE highlighted uncertainties in the clinical trial results. It concluded there wasn’t enough evidence that these benefits are sustained in the long run, which made it difficult to properly assess whether the drug would offer value for money to the NHS.

Paula Chadwick said, “There’s a real and urgent need for fresh treatment options for patients living with small cell lung cancer. We’ve seen great advances in how non-small cell lung cancer can be treated, with combination treatments involving immunotherapies enabling more patients to live better for longer.

“Currently, the picture for small cell is less encouraging. This really needs to change. We urge NICE to look again at the evidence, as data from clinical trials suggest that adding atezolizumab to the treatment patients are currently offered can help them live longer and give them more time.

“Given that context, we can only view this ruling by NICE as deeply disappointing”.

NICE is due to review this decision in February.