A new treatment for advanced bowel cancer has been approved by
NICE and is available on the NHS from today (Tuesday, 22
April).The treatment combines two immunotherapies - nivolumab
(Opdivo) and ipilimumab (Yervoy) - and it is estimated just over
700 people with untreated metastatic colorectal cancer with high
microsatellite instability or mismatch repair deficiency will be
eligible to receive it.
Colorectal cancer accounts for 11% of new UK cancer cases, with
about 7% of metastatic cases having the specific biomarkers this
treatment targets. These markers are associated with poorer
outcomes and a greater risk of death than metastatic colorectal
cancer without them.
There is a need for additional treatment options for people with
this sub-type of metastatic colorectal cancer that can be
aggressive and particularly difficult to treat.Clinical experts
told NICE's independent appraisal committee that an additional
first-line treatment option that shrank the tumours, allowing
potentially curative surgery for some people who have who have
unresectable but not metastatic cancer, would be welcomed by
patients. The committee heard that up to a third of people who
have unresectable but not metastatic cancer who received this new
combination treatment might be able to benefit in this
way.Clinical evidence showed the dual treatment to be effective
against standard care, which is either chemotherapy or
pembrolizumab.This recommendation changes a previous draft
guidance decision by NICE's independent committee not to
recommend. The company submitted additional clinical evidence
allowing the committee to recommend the treatment as cost
effective.
The treatment is available to the NHS with confidential
discounts.
The NICE recommendation comes three weeks after UK marketing
authorisation was granted by Medicines and Healthcare Regulatory
Agency (MHRA) on 4 April 2025.
Nivolumab (Opdivo) with ipilimumab (Yervoy) is made by
Bristol-Myers-Squibb.
Read the full final draft guidance for nivolumab with ipilimumab for
untreated metastatic colorectal cancer with high microsatellite
instability or mismatch repair deficiency.
