cabozantinib (Cabometyx)

following a full submission assessed under the end of life and orphan equivalent medicine process:

cabozantinib (Cabometyx®) is not recommended for use within NHSScotland.

Indication under review: as monotherapy for the treatment of adult patients with locally advanced or metastatic differentiated thyroid carcinoma (DTC), refractory or not eligible to radioactive iodine (RAI) who have progressed during or after prior systemic therapy.

In a double-blind, randomised, phase III study, progression-free survival was significantly improved with cabozantinib compared with placebo in patients with DTC, refractory or not eligible to RAI who had progressed after one or two prior tyrosine kinase inhibitors.

The submitting company’s justification of the treatment’s cost in relation to its health benefits was not sufficient and in addition the company did not present a sufficiently robust economic analysis to gain acceptance by SMC.

This advice takes account of the views from a Patient and Clinician Engagement (PACE) meeting.