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A new treatment for advanced bowel cancer has been approved by the National Institute for Health and Care Excellence (NICE) and made available on the NHS, reversing previous draft guidance that did not recommend the combined immunotherapies nivolumab (Opdivo) and ipilimumab (Yervoy).
In documents supporting its decision, NICE said that clinical evidence showed the dual treatment to be effective against standard care, which is either chemotherapy or pembrolizumab.
According to NICE, it is estimated more than 700 people with untreated metastatic colorectal cancer with high microsatellite instability or mismatch repair deficiency will be eligible to receive the new treatment, which is now available to the NHS with confidential discounts after the manufacturer — Bristol-Myers Squibb — submitted additional clinical evidence allowing the committee to recommend the treatment as cost effective.
NICE cited data that show colorectal cancer accounts for 11% of new UK cancer cases, with about 7% of metastatic cases having the specific biomarkers this treatment targets.
These markers are associated with poorer outcomes and a greater risk of death than metastatic colorectal cancer without them.
A statement from NICE said: “There is a need for additional treatment options for people with this sub-type of metastatic colorectal cancer that can be aggressive and particularly difficult to treat.”
The draft guidance, published in February 2025, did not recommend nivolumab with ipilimumab for this form of cancer.
Clinical experts told NICE’s independent appraisal committee that an additional first-line treatment option that shrank the tumours, allowing potentially curative surgery for some people who have unresectable but not metastatic cancer, would be welcomed by patients.
The committee also heard that up to one-third of people who have unresectable but not metastatic cancer who received this new combination treatment might be able to benefit in this way.
Commenting on NICE’s final guidance, Genevieve Edwards, chief executive at Bowel Cancer UK, said: “We’re pleased that NICE has decided to recommend this drug combination as an option for eligible patients on the NHS.
“Additional treatment options for advanced bowel cancer patients, including this combination of treatment, can provide patients with increased chances for improved quality of life and more precious time with their loved ones.”
