The Pharmaceutical Benefits Advisory Committee has supported a request to list cabozantinib on the PBS for the treatment of stage IV clear cell variant renal cell carcinoma.

The positive PBAC recommendation from a December 2017 meeting was justified on a cost-minimisation basis against nivolumab.

“The PBAC considered that cabozantinib had non-inferior efficacy compared to nivolumab and whilst there was possibly increased toxicity associated, this was manageable and balanced against a clinical need for an alternative to immunotherapy in this patient population.”

At the November 2017 meeting the PBAC supported listing atezolizumab for the treatment of locally advanced (stage IIIB) or metastatic (stage IV) NSCLC with progression on or after prior platinum based chemotherapy.

That decision too hinged on the basis of cost-minimisation against nivolumab.

“In making this recommendation, the PBAC considered that atezolizumab was non-inferior in effectiveness and safety compared with nivolumab, which is currently listed on the PBS for this population.”

“Consistent with the current listing of nivolumab, the PBAC advised that PBS-subsidised access to atezolizumab should not be conditional to the patient’s PD-L1 expression status.”

At its next meeting in March 2018 the PBAC is to consider a listing for irinotecan (Onivyde) for patients with metastatic pancreatic cancer. The PBAC will also consider applications for regorafenib (Stivarga) to be listed on the PBS for the treatment of patients with unresectable hepatocellular carcinoma who have progressed on sorafenib treatment. A PBS listing is also being sought for ramucirumab (Cyramza) for the treatment of advanced gastric or gastro-oesophageal junction adenocarcinomas, in combination with paclitaxel after prior platinum and fluoropyrimidine chemotherapy.

The PBAC will also consider a request to amend the PBS listing for cetuximab (Erbitux) to include treatment of patients with recurrent or metastatic squamous cell carcinoma of the head and neck.