atezolizumab (Tecentriq)

following a full submission considered under the end of life and orphan equivalent process:

atezolizumab (Tecentriq®) is not recommended for use  within NHS Scotland.

Indication under review: As monotherapy for the treatment of adult patients with locally advanced or metastatic urothelial carcinoma after prior platinum-containing chemotherapy or who are considered cisplatin ineligible.

In a single arm, open-label, phase II study of patients with locally advanced or metastatic urothelial carcinoma who had received no previous treatment for metastatic disease and who were ineligible for cisplatin therapy, treatment with atezolizumab resulted in an objective response in 19% of patients.

The submitting company’s justification of the treatment’s cost in relation to its health benefits was not sufficient and in addition the company did not present a sufficiently robust clinical and economic analysis to gain acceptance by SMC.

This advice takes account of the views from a Patient and Clinician Engagement (PACE) meeting.