NICE turns down Opdivo for adjuvant melanoma therapy

Source: PMLive, October 2018

England’s cost effectiveness watchdog NICE has decided not to recommend use of the PD-1 inhibitor as an adjuvant treatment for NHS patients with stage III and IV melanoma – in other words to prevent the cancer recurring after surgical resection.

In an emailed statement, NICE said that it took the decision because the reviewing committee “concluded the clinical effectiveness for overall survival was very uncertain” and was also unconvinced by cost effectiveness estimates for Opdivo in this setting.

The draft guidance – which is out for public comment until 28 September – says that the uncertainty about Opdivo’s benefits stems from having “no trials directly comparing adjuvant nivolumab with routine surveillance, which is usual current management for completely resected stage III and IV melanoma.”