Wednesday 06 June 2018 at 08:17
Life-lengthening lung cancer drug approved for general commissioning
The immunotherapy, pembrolizumab, is now available on the NHS for people with non-small cell lung cancer (NSCLC), after the National Institute of Health and Care Excellence (NICE) approved the drug for general commissioning.
The new drug could help up to 1,800 people every year
Previously available via the Cancer Drug Fund (CDF), this decision means pembrolizumab, will now be available as a first line treatment for patients whose tumours express, at least, 50% PDL1.
PDL1 is a biomarker commonly used to predict a person’s response to immune checkpoint inhibitors, like pembrolizumab.
The decision means the immunotherapy is the first drug to break the new budget threshold. The controversial policy allows NHS England to restrict or delay medicines that cost more than £20million per year, even if it is deemed cost-effective.
Pembrolizumab costs £84,000 per patient at full price. However, officials believe the prospect of such delays has help persuaded the drugmaker, MSD, to agree to a confidential discount to bring it below the threshold.
About 1,800 patients a year will now be eligible.
"This really feels like the start of something new for us and for lung cancer patients. Up till now, funding for lung cancer has simply not been proportionate to the impact of this disease. This decision is a long time coming."
Paula Chadwick, chief executive of Roy Castle Lung Cancer Foundation
Roy Castle Lung Cancer Foundation, the only UK charity dedicated solely to lung cancer, is delighted by the news:
"This really feels like the start of something new for us and for lung cancer patients,” said Paula Chadwick, chief executive of the Foundation who has always campaigned as the 'voice' of patients for treatments and funding.
“Lung cancer kills over 35,000 people in the UK every year, and, up till now, funding for treatments, for patient care, for early detection, for prevention and for research has simply not been proportionate to the impact of this disease.
"We have seen breakthrough moments for other cancers - that's where the interest has often been - but not so much for lung cancer.
"Pembrolizumab can offer patients an extra choice, a fresh option - and may extend their lives, giving them more time, and better quality of life, to spend with their families and their loved ones. How can you even put a price on that?
"In the words of Becky Crossley, one of the patients we work with closely, and who has supported our campaigns, 'Lung cancer can kill quickly. My husband and children face losing me within months. We want years.'
That's the kind of fresh hope that pembrolizumab and the other new treatments coming into use now offer people living with lung cancer. Instead of it being a death sentence, now there's new hope".
Becky is living with stage 4 lung cancer and recently supported our #HeadHigh campaign
How does pembrolizumab work?
Pembrolizumab is an immunotherapy, a new class of medicines that boost the body’s own natural defences against cancer.
The drug has been one of the focuses of this year’s American Society of Clinical Oncology’s (ASCO) Annual meeting in Chicago where the results of a large, randomised phase III trial showed the immunotherapy is a more effective initial treatment than chemotherapy for the majority of NSCLC patients.
Patients first treated with pembrolizumab lived, on average, 4-8 months longer than those who received chemotherapy.
They also had a better quality of life, with severe side effects occurring in fewer patients receiving the immunotherapy than chemotherapy (18% vs. 41%).
"We all know how gruelling chemotherapy can be on a patient so that there is now a new treatment option which minimising the side effects and lengthens life is fantastic news for hundreds of patients and their families."
Latest research shows pembrolizumab to lengthen the life of late stage lung cancer patients compared to chemotherapy
The study’s lead author and medical oncologist at the Sylvester Comprehensive Cancer Center at the University of Miami, Gilberto Lopes MD MBA, explains:
“A large number of patients with lung cancer now have a new treatment option with better efficacy and fewer side effects than standard chemotherapy.
“Our study shows that pembrolizumab provides more benefit than chemotherapy for two thirds of all people with the most common type of lung cancer.”
About the study
According to the authors, this study is the largest clinical trial of pembrolizumab as a standalone therapy.
The study involved 1,274 people with locally advanced or metastatic NSCLC who were randomly assigned chemotherapy (paclitaxel plus carboplatin or pemetrexed plus carboplatin) or pembrolizumab.
Researchers also explored the treatment benefits based on PDL1 expression. It found that patients with higher PDL1 expression lived, on average, for longer:
- PDL1 50% or more: 20 months with pembrolizumab vs. 12.2 months with chemotherapy
- PDL1 20% or more: 17.7 months with pembrolizumab vs. 13 months with chemotherapy
- PDL1 1% or more: 16.7 months with pembrolizumab vs. 12.1 months with chemotherapy.
Paula Chadwick continues:
“The latest research coming out of the ASCO conference suggests that pembrolizumab not only gives people with lung cancer more time with their families but quality time.
“We all know how gruelling chemotherapy can be on a patient so that there is now a new treatment option which minimising the side effects and lengthens life is fantastic news for hundreds of patients and their families.”