DURVALUMAB

The PBAC recommended the listing of durvalumab for use both before and after surgery in patients with gastric or gastroesophageal junction cancers (GC/GOJC) who are eligible for the chemotherapy combination of fluorouracil, leucovorin, oxaliplatin, and docetaxel (FLOT) before surgery. The PBAC acknowledged that these cancers are challenging to treat and have significant impacts on quality of life despite currently available treatment options. The PBAC was satisfied that addition of durvalumab to existing treatment before and after surgery reduces the risk of the cancer returning and helps patients with GC/GOJC live longer when compared with current standard treatments. The PBAC considered durvalumab would be cost effective with a price reduction to reflect evidence of benefit, cost of other medicines it had recommended for use before and after surgery, uncertainty about subsequent immunotherapy, and the changing landscape with respect to PBS listings for immunotherapy. The PBAC considered that with some minor adjustments to the economic modelling, the estimated cost to the government was reasonable.