pembrolizumab (Keytruda)

a full submission assessed under the end of life medicine process:

pembrolizumab (Keytruda®) is accepted for restricted use within NHSScotland.

Indication under review: In combination with carboplatin and either paclitaxel or nabpaclitaxel,
for the first-line treatment of metastatic squamous non-small cell lung cancer
(NSCLC) in adults.

SMC restriction: in combination with carboplatin and paclitaxel in patients whose tumours
express programmed death ligand 1 (PD-L1) with a <50% tumour proportion score (TPS), or
in those whom it has not been possible to evaluate PD-L1 TPS. Treatment with
pembrolizumab is subject to a two-year clinical stopping rule.

Pembrolizumab in combination with platinum based doublet chemotherapy was associated
with a progression-free survival and overall survival benefit over platinum based doublet
chemotherapy in patients with treatment naïve metastatic squamous NSCLC.

This SMC advice takes account of the benefits of a Patient Access Scheme (PAS) that
improves the cost-effectiveness of pembrolizumab. This advice is contingent upon the
continuing availability of the PAS in NHSScotland or a list price that is equivalent or lower.

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