11 April 2018 - Draft final guidance proposes different access streams for first-line and second-line use in patients with Merkel cell carcinoma.

Avelumab is recommended as an option for treating metastatic Merkel cell carcinoma in adults, only if they have had one or more lines of chemotherapy for metastatic disease.

Avelumab is recommended for use within the Cancer Drugs Fund as an option for treating metastatic Merkel cell carcinoma in adults, only if:

• they have not had chemotherapy for metastatic disease and
  
• the conditions in the managed access agreement for avelumab are followed
  

Read NICE Final Appraisal Determination