Using the agreed starting and stopping criteria dostarlimab (Jemperli^®) can be made available within NHS Wales for the first-line treatment of locally advanced stage II/III deficient mismatch repair (dMMR) / high microsatellite instability (MSI-H) rectal cancer. This recommendation applies only in circumstances where the approved commercial arrangement price is applied.

The risks and benefits of the off-label use of dostarlimab (Jemperli^®) for this indication should be clearly stated and discussed with the patient to allow informed consent.

Providers should consult the relevant guidelines on prescribing unlicensed medicines before any off-label medicines are prescribed.

This advice will be reviewed after 12 months or earlier if new evidence becomes available.