It is the view of the One Wales Medicines Assessment Group (OWMAG) that nivolumab should not be supported within NHS Wales for monotherapy as a first-line treatment for patients with metastatic or locally advanced and unresectable, deficient mismatch repair (dMMR) / high microsatellite instability (MSI‑H) oesophageal and gastric cancer.

Individual Patient Funding Request (IPFR) consideration remains appropriate for those patients who are likely to obtain significantly more clinical benefit from the intervention than would normally be expected at a reasonable value for money.

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