The National Institute for Health and Care Excellence (NICE) have approved Roche's lung cancer medicine atezolizumab, brand name Tecentriq▼, as an option in the treatment of a type of lung cancer called non-squamous, non-small cell lung cancer (NSCLC).
This means that atezolizumab prescribed with the other medicines bevacizumab, carboplatin and paclitaxel is available on the NHS.
It is a possible treatment for metastatic non-squamous non-small-cell lung cancer (NSCLC) in adults if:
- they have not had treatment for their metastatic NSCLC before and their PD-L1 tumour proportion score is below 50% or
- targeted therapy for epidermal growth factor receptor (EGFR)‑positive or anaplastic lymphoma kinase (ALK)‑positive NSCLC has not worked.
Treatment should be stopped at 2 years of continuous treatment, or earlier if atezolizumab stops working or the disease progresses on bevacizumab.
If you are not eligible for atezolizumab with bevacizumab, carboplatin and paclitaxel but are already taking it, you should be able to continue until you and your doctor decide when best to stop.
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Why NICE made this decision
The medicine pemetrexed plus carboplatin or cisplatin, with or without pemetrexed maintenance, is the current treatment for:
- untreated metastatic non-squamous NSCLC (with no EGFR- or ALK‑positive gene mutations) with a PD‑L1 tumour proportion score between 0% and 49% and
- metastatic non-squamous EGFR- or ALK-positive NSCLC when targeted therapy is either not an option or has failed.
Pembrolizumab monotherapy is the current treatment for untreated metastatic non-squamous NSCLC with a PD‑L1 tumour proportion score of at least 50%.
An indirect comparison of studies suggests that people having atezolizumab plus bevacizumab, carboplatin and paclitaxel live longer than those having pemetrexed plus carboplatin or cisplatin, with or without pemetrexed maintenance. This comparison also suggests that they live for longer before their condition worsens.
About Tecentriq (source EMA)
Tecentriq is a cancer medicine for treating urothelial cancer (a cancer of the bladder and urinary system) and non-small cell lung cancer.
In urothelial cancer that is locally advanced or has spread, Tecentriq is used on its own in patients who have previously been treated with platinum-based cancer medicines or in patients who cannot be treated with cisplatin (a platinum-based medicine) and whose cancer cells (at least 5%) have a protein called PD-L1.
In non-small cell lung cancer that is locally advanced or has spread, Tecentriq is used on its own in patients who have had chemotherapy before. In patients whose cancer has spread and who have not yet had chemotherapy, Tecentriq is used in combination with the cancer medicines bevacizumab, paclitaxel and carboplatin. Patients with non-small cell lung cancer with certain genetic mutations (changes) should have targeted treatments before receiving Tecentriq.
The active substance in Tecentriq, atezolizumab, is a monoclonal antibody, a type of protein designed to recognise and attach to a protein called PD-L1, which is present on the surface of many cancer cells.
PD-L1 acts to switch off immune cells that would otherwise attack the cancer cells. By attaching to PD-L1 and reducing its effects, Tecentriq increases the ability of the immune system to attack the cancer cells and thereby slow down progression of the disease.
Tecentriq was first made available in the EU in 2017. It is manufactured by Roche.
European Medicines Agency website page for Tecentriq
Links available in full article
© NICE 
Atezolizumab in combination for treating metastatic non-squamous non-small-cell lung cancer. Technology appraisal guidance [TA584]. Published date: 05 June 2019
Available from: See Link below. All rights reserved. Subject to Notice of rights
NICE guidance is prepared for the National Health Service in England. All NICE guidance is subject to regular review and may be updated or withdrawn. NICE accepts no responsibility for the use of its content in this product/publication.
The information provided by NICE was accurate at the time this article was issued.
NICE information on Tecentriq in treating NSCLC
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