Atezolizumab for adjuvant treatment of resected non-small-cell lung cancer

Atezolizumab can be used, within its marketing authorisation, as an option for the adjuvant treatment of non-small-cell lung cancer (NSCLC) after complete resection and platinum-based chemotherapy in adults when: • there is a high risk of recurrence • 50% or more of tumour cells express PD‑L1 • the cancer is not epidermal growth factor receptor (EGFR)‑mutant or anaplastic lymphoma kinase (ALK)‑positive. Atezolizumab can only be used if the company provides it according to the commercial arrangement . there is a high risk of recurrence 50% or more of tumour cells express PD‑L1 the cancer is not epidermal growth factor receptor (EGFR)‑mutant or anaplastic lymphoma kinase (ALK)‑positive. Atezolizumab can only be used if the company provides it according to the commercial arrangement .

If people with the condition and their healthcare professional consider atezolizumab to be 1 of a range of suitable treatments, after discussing the advantages and disadvantages of all the options, the least expensive should be used. Administration costs, dosages, price per dose and commercial arrangements should all be taken into account. What this means in practice Atezolizumab must be funded in the NHS in England for the condition and population in the recommendations, if it is considered the most suitable treatment option. Atezolizumab must be funded in England within 30 days of final publication of this guidance. There is enough evidence to show that atezolizumab 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 . This evaluation reviews the evidence for atezolizumab for the adjuvant treatment of resected NSCLC (NICE technology appraisal guidance TA823). It also reviews new data collected as part of the managed access agreement, which includes evidence from clinical trials. Usual adjuvant treatment after complete resection and platinum-based chemotherapy of NSCLC is pembrolizumab, a monoclonal antibody. Atezolizumab works in a similar way and is an alternative to pembrolizumab. Clinical trial evidence shows that atezolizumab increases how long people live compared with active monitoring. Atezolizumab has not been directly compared in a clinical trial with pembrolizumab. But indirect comparisons suggest that it is likely to work at least as well in terms of how long people live cancer-free and how long they live. A cost comparison suggests that the costs for atezolizumab are similar to or less than those for pembrolizumab. Administration, adverse-event and other resource-use costs are also expected to be similar to or less than those for pembrolizumab. To be recommended as a treatment option, atezolizumab must cost less or have similar costs to 1 relevant comparator recommended in a published NICE technology appraisal guidance (see NICE's cost-comparison methods ), so atezolizumab can be used. For all evidence, see the committee papers . For more information on NICE's evaluation of pembrolizumab, see the committee discussion section in NICE's technology appraisal guidance on pembrolizumab for adjuvant treatment of resected NSCLC .

Atezolizumab (Tecentriq, Roche) is indicated for 'adjuvant treatment following complete resection and platinum-based chemotherapy for adult patients with NSCLC with a high risk of recurrence whose tumours have PD‑L1 expression on ≥ 50% of tumour cells and who do not have EGFR‑mutant or ALK‑positive NSCLC'.

The dosage schedule is available in the summary of product characteristics for atezolizumab .

The list price for atezolizumab is £2,665.38 for an 840‑mg vial or £3,807.69 for a 1,200‑mg vial (excluding VAT, BNF online, accessed March 2025).

The company has a commercial arrangement . This makes atezolizumab available to the NHS with a discount. The size of the discount is commercial in confidence.

For information, the Carbon Reduction Plan for UK carbon emissions is published on Roche's website on sustainability .

Section 7 of the National Institute for Health and Care Excellence (Constitution and Functions) and the Health and Social Care Information Centre (Functions) Regulations 2013 requires integrated care boards, NHS England and, with respect to their public health functions, local authorities to comply with the recommendations in this evaluation within 90 days of its date of publication. Because atezolizumab has been recommended through the cost-comparison process , NHS England and integrated care boards have agreed to provide funding to implement this guidance 30 days after publication.

Chapter 2 of Appraisal and funding of cancer drugs from July 2016 (including the new Cancer Drugs Fund) – A new deal for patients, taxpayers and industry states that for those drugs with a draft recommendation for routine commissioning, interim funding will be available (from the overall Cancer Drugs Fund budget) from the point of marketing authorisation, or from release of positive draft guidance, whichever is later. Interim funding will end 90 days after positive final guidance is published (or 30 days in the case of drugs with an Early Access to Medicines Scheme designation or cost comparison evaluation), at which point funding will switch to routine commissioning budgets. The NHS England Cancer Drugs Fund list provides up-to-date information on all cancer treatments recommended by NICE since 2016. This includes whether they have received a marketing authorisation and been launched in the UK.

The Welsh ministers have issued directions to the NHS in Wales on implementing NICE technology appraisal guidance. When a NICE technology appraisal guidance recommends the use of a drug or treatment, or other technology, the NHS in Wales must usually provide funding and resources for it within 60 days of the first publication of the final draft guidance.

When NICE recommends a treatment 'as an option', the NHS must make sure it is available within the period set out in the paragraphs above. This means that, if a patient has resected non-small-cell lung cancer and the healthcare professional responsible for their care thinks that atezolizumab is the right treatment, it should be available for use, in line with NICE's recommendations.

Atezolizumab can be used, within its marketing authorisation, as an option for the adjuvant treatment of non-small-cell lung cancer (NSCLC) after complete resection and platinum-based chemotherapy in adults when: • there is a high risk of recurrence • 50% or more of tumour cells express PD‑L1 • the cancer is not epidermal growth factor receptor (EGFR)‑mutant or anaplastic lymphoma kinase (ALK)‑positive. Atezolizumab can only be used if the company provides it according to the commercial arrangement . there is a high risk of recurrence 50% or more of tumour cells express PD‑L1 the cancer is not epidermal growth factor receptor (EGFR)‑mutant or anaplastic lymphoma kinase (ALK)‑positive. Atezolizumab can only be used if the company provides it according to the commercial arrangement .

If people with the condition and their healthcare professional consider atezolizumab to be 1 of a range of suitable treatments, after discussing the advantages and disadvantages of all the options, the least expensive should be used. Administration costs, dosages, price per dose and commercial arrangements should all be taken into account. What this means in practice Atezolizumab must be funded in the NHS in England for the condition and population in the recommendations, if it is considered the most suitable treatment option. Atezolizumab must be funded in England within 30 days of final publication of this guidance. There is enough evidence to show that atezolizumab 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 . This evaluation reviews the evidence for atezolizumab for the adjuvant treatment of resected NSCLC (NICE technology appraisal guidance TA823). It also reviews new data collected as part of the managed access agreement, which includes evidence from clinical trials. Usual adjuvant treatment after complete resection and platinum-based chemotherapy of NSCLC is pembrolizumab, a monoclonal antibody. Atezolizumab works in a similar way and is an alternative to pembrolizumab. Clinical trial evidence shows that atezolizumab increases how long people live compared with active monitoring. Atezolizumab has not been directly compared in a clinical trial with pembrolizumab. But indirect comparisons suggest that it is likely to work at least as well in terms of how long people live cancer-free and how long they live. A cost comparison suggests that the costs for atezolizumab are similar to or less than those for pembrolizumab. Administration, adverse-event and other resource-use costs are also expected to be similar to or less than those for pembrolizumab. To be recommended as a treatment option, atezolizumab must cost less or have similar costs to 1 relevant comparator recommended in a published NICE technology appraisal guidance (see NICE's cost-comparison methods ), so atezolizumab can be used. For all evidence, see the committee papers . For more information on NICE's evaluation of pembrolizumab, see the committee discussion section in NICE's technology appraisal guidance on pembrolizumab for adjuvant treatment of resected NSCLC .

Atezolizumab can be used, within its marketing authorisation, as an option for the adjuvant treatment of non-small-cell lung cancer (NSCLC) after complete resection and platinum-based chemotherapy in adults when: • there is a high risk of recurrence • 50% or more of tumour cells express PD‑L1 • the cancer is not epidermal growth factor receptor (EGFR)‑mutant or anaplastic lymphoma kinase (ALK)‑positive. Atezolizumab can only be used if the company provides it according to the commercial arrangement . there is a high risk of recurrence 50% or more of tumour cells express PD‑L1 the cancer is not epidermal growth factor receptor (EGFR)‑mutant or anaplastic lymphoma kinase (ALK)‑positive. Atezolizumab can only be used if the company provides it according to the commercial arrangement .

If people with the condition and their healthcare professional consider atezolizumab to be 1 of a range of suitable treatments, after discussing the advantages and disadvantages of all the options, the least expensive should be used. Administration costs, dosages, price per dose and commercial arrangements should all be taken into account. What this means in practice Atezolizumab must be funded in the NHS in England for the condition and population in the recommendations, if it is considered the most suitable treatment option. Atezolizumab must be funded in England within 30 days of final publication of this guidance. There is enough evidence to show that atezolizumab 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 . This evaluation reviews the evidence for atezolizumab for the adjuvant treatment of resected NSCLC (NICE technology appraisal guidance TA823). It also reviews new data collected as part of the managed access agreement, which includes evidence from clinical trials. Usual adjuvant treatment after complete resection and platinum-based chemotherapy of NSCLC is pembrolizumab, a monoclonal antibody. Atezolizumab works in a similar way and is an alternative to pembrolizumab. Clinical trial evidence shows that atezolizumab increases how long people live compared with active monitoring. Atezolizumab has not been directly compared in a clinical trial with pembrolizumab. But indirect comparisons suggest that it is likely to work at least as well in terms of how long people live cancer-free and how long they live. A cost comparison suggests that the costs for atezolizumab are similar to or less than those for pembrolizumab. Administration, adverse-event and other resource-use costs are also expected to be similar to or less than those for pembrolizumab. To be recommended as a treatment option, atezolizumab must cost less or have similar costs to 1 relevant comparator recommended in a published NICE technology appraisal guidance (see NICE's cost-comparison methods ), so atezolizumab can be used. For all evidence, see the committee papers . For more information on NICE's evaluation of pembrolizumab, see the committee discussion section in NICE's technology appraisal guidance on pembrolizumab for adjuvant treatment of resected NSCLC .