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Kawasaki disease — UKMLA MCQ

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HardPaediatricsKawasaki diseaseUKMLAMRCP Part 1

An adult has relapsed diffuse large B-cell lymphoma after three systemic treatment lines. Lisocabtagene maraleucel and axicabtagene ciloleucel are both suitable, and shared discussion identifies no clinical or practical advantage. Which selection rule follows NICE?

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Correct answer: C — Use the least expensive suitable CAR-T option

The best answer is “Use the least expensive suitable CAR-T option”. TA1159 supports lisocabtagene after at least two lines for relapsed or refractory DLBCL or PMBCL. When liso-cel and axi-cel are both suitable, NICE directs use of the least expensive option after discussing advantages and disadvantages, including administration and commercial costs. Appraisal date, chronology and PD-L1 do not determine choice.

Reference: NICE TA1159, Lisocabtagene maraleucel after two or more lines for large B-cell lymphoma: https://www.nice.org.uk/guidance/ta1159/chapter/1-Recommendations