Reason for request

New indication

Key points

Favourable opinion for reimbursement in combination with pembrolizumab in the treatment of adult patients with advanced or recurrent endometrial carcinoma (EC) who have disease progression on or following prior treatment with a platinum-containing therapy in any setting and are not candidates for curative surgery or radiation.

What therapeutic improvement?

Therapeutic improvement compared to single-agent chemotherapy with doxorubicin or paclitaxel in the second-line treatment of advanced endometrial carcinoma.

Role in the care pathway?

In patients with advanced or recurrent disease, who have disease progression on or following prior treatment with a platinum-containing therapy, there is no treatment/protocol considered to be the standard care. The treatment options are:

  • Platinum-containing dual-agent chemotherapy, to be favoured in patients having had a platinum-free interval of more than 6 months,
  • single-agent chemotherapy with doxorubicin, paclitaxel, oxaliplatin or ifosfamide. There is no solid data enabling single-agent chemotherapies to be ranked in the event of progression following platinum-containing chemotherapy.

Role of the medicinal product in the care pathway

LENVIMA (lenvatinib), in combination with pembrolizumab (KEYTRUDA), is a second-line treatment in adult patients with advanced or recurrent endometrial carcinoma (EC) who have disease progression on or following prior treatment with a platinum-containing therapy in any setting and are not candidates for curative surgery or radiation.


Clinical Benefit

Substantial

The Committee deems that the clinical benefit of LENVIMA (lenvatinib) in the context of its indication extension, in combination with pembrolizumab, is substantial in the MA indication.


Clinical Added Value

moderate

Considering:

  • demonstration in a randomised, open-label phase 3 study of the superiority of the LENVIMA (lenvatinib) and KEYTRUDA (pembrolizumab) combination compared to single-agent chemotherapy with doxorubicin or paclitaxel, particularly in terms of:
    • progression-free survival (absolute increase of 3.4 months, HR=0.56 [CI95%: 0.47-0.66]),
    • overall survival (absolute increase of 6.9 months, HR=0.62 [CI95%: 0.51-0.75])

and despite:

  • a safety profile for the LENVIMA (lenvatinib) and KEYTRUDA (pembrolizumab) combination that is less favourable than that for single-agent chemotherapy, marked by additional toxicity with, in particular, more serious adverse events (53% versus 30%),
  • the absence of any formal conclusion that can be drawn based on the quality of life results,

the Transparency Committee considers that LENVIMA (lenvatinib) in combination with KEYTRUDA (pembrolizumab) provides a moderate clinical added value (CAV III) compared to single-agent chemotherapy with doxorubicin or paclitaxel in the second-line treatment of adult patients with advanced or recurrent endometrial carcinoma (EC) who have disease progression on or following prior treatment with a platinum-containing therapy in any setting and are not candidates for curative surgery or radiation.

 

 


Avis économique

Ce produit a fait l'objet d'un avis économique rendu par la Commission d'évaluation économique et de santé publique (CEESP) le 10 mai 2022. L’avis économique porte sur une indication superposable à l’AMM.  

La CEESP a été en mesure de conclure sur le niveau d’efficience du produit, avec un ratio différentiel coût-résultat (RDCR) de 169 780 €/QALY versus la chimiothérapie par doxorubicine ou paclitaxel sur un horizon temporel de 10 ans. L’incertitude entourant le résultat est explorée en analyses de sensibilité et le résultat est sensible au maintien de l’effet traitement dans le temps. 

> LENVIMA - avis économique (pdf)

 

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