NICE update on pembrolizumab for platinum-resistant ovarian cancer patients in England
NICE issue draft guidance decision not to recommend pembrolizumab for platinum-resistant ovarian cancer patients in England.
NICE have announced their draft decision not to recommend pembrolizumab with chemotherapy, with or without bevacizumab, for treating platinum-resistant recurrent ovarian cancer after 1 or 2 treatments.
NICE have been assessing the cost-effectiveness of the drug pembrolizumab (brand name Keytruda) and decided they cannot approve the drug at this time in women with:
- ovarian, fallopian tube or primary peritoneal cancer
- who have become resistant to platinum chemotherapy
- whose cancer has come back after one or two systemic treatments
- whose cancer tests positive for PD-L1 with a combined positive score (CPS) of 1 or more*
- to be used alongside paclitaxel, with or without the addition of bevacizumab (also known as Avastin).
This decision is disappointing for women with ovarian cancer, because of the hopeful research suggesting this treatment combination offers women more time with their loved ones.
Why did NICE make this decision?
The draft decision explains that they cannot recommend this drug at this time because they need further evidence in some areas to be able to make an accurate assessment of whether it is cost-effective to use on the NHS. This included needing data comparing pembrolizumab with mirvetuximab soravtansine (Elahere), and further data on the overall survival of patients using pembrolizumab.
This is a draft decision. This doesn’t mean pembrolizumab won’t ever be made available on the NHS in England, but rather that NICE requires more information before making a final decision.
You can read the full details of the draft guidance here.
What is pembrolizumab?
Pembrolizumab (brand name Keytruda) is a type of immunotherapy, which means it helps a person’s own immune system to fight cancer cells in their body. It is already available on the NHS for some types of cancer, including non-small cell lung cancer, melanoma, and cervical cancer.
You can read more about pembrolizumab here.
How can you help?
Ovarian Cancer Action will now put together a response to the draft guidance and questions raised by the committee. You can feed back your opinions and add evidence to our response by sending us an email by 14th August to info@ovarian.org.uk
Alternatively, you can comment directly as an individual through the NICE website.
The deadline to comment in this way is 25th August
Once comments have been received, the NICE committee will meet again on 15th September 2026 to discuss the evidence and put together their final guidance.
The updated decision is expected to be published in November 2026.
* PL-D1 (programmed death-ligand 1) is a protein that some cancer cells use to hide from the immune system. Drugs that target this pathway remove this protection which helps the body's immune system find and destroy the cells. The CPS (combined positive score) measures the proportion of cancer cells that express PL-D1 compared to the total number of tumour cells.
| Bevacizumab (Avastin) |
A targeted cancer treatment that works by reducing the blood supply that tumours need to grow. |
| Combined Positive Score (CPS) |
A score used to measure how much PD-L1 is present in a tumour. A higher score suggests a cancer may be more likely to respond to certain immunotherapies. |
| Elahere (Mirvetuximab Soravtansine) |
A targeted treatment for some people with ovarian cancer. NICE requested additional information comparing pembrolizumab with Elahere. |
| Immunotherapy |
A type of treatment that helps the body's immune system recognise and attack cancer cells. |
| Keytruda |
The brand name for pembrolizumab. |
|
NICE (National Institute for Health and Care Excellence) |
The organisation that assesses whether treatments should be available on the NHS in England. |
| Paclitaxel |
A chemotherapy drug commonly used to treat ovarian cancer and other cancers. |
| PD-L1 (Programmed Death-Ligand 1) |
A protein found on some cancer cells that can help them hide from the immune system. |
| Pembrolizumab |
An immunotherapy drug that blocks the PD-1/PD-L1 pathway, helping the immune system find and attack cancer cells. |
| Platinum Chemotherapy |
A group of chemotherapy drugs, such as carboplatin and cisplatin, commonly used to treat ovarian cancer. |
| Platinum-Resistant Cancer |
Cancer that continues to grow or returns within a relatively short period after treatment with platinum-based chemotherapy. |
| Primary Peritoneal Cancer |
A rare cancer that develops in the lining of the abdomen (the peritoneum) and behaves similarly to ovarian cancer. |
| Recurrent Cancer |
Cancer that has returned after previous treatment. |
| Systemic Treatment |
A treatment that travels through the bloodstream to reach cancer cells throughout the body, such as chemotherapy, targeted therapy or immunotherapy. |
Outside of England
Access to medicines is decided by different bodies depending on where in the UK you live.
In England, which drugs are available on the NHS is decided by National Institute for Health and Care Excellence (NICE).
In Wales, the medicines guidance produced by NICE is followed, and this is overseen by the All Wales Medicines Strategy Group (AWMSG).
In Northern Ireland, the Department of Health makes decisions, but they often follow NICE.
In Scotland, the Scottish Medicines Consortium (SMC) makes decisions about NHS Scotland and this is not related to NICE decisions
