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Add new lung cancer treatment to Cancer Drugs Fund, says NICE

3000+ patients set to benefit from provisional thumbs up for immunotherapy drug Keytruda

Caroline White

Friday, 23 November 2018

A new immunotherapy drug for people with lung cancer should be made available on the Cancer Drugs Fund (CDF), the National Institute for Health and Care Excellence (NICE) has provisionally recommended.

More than 3000 patients in England may be eligible for pembrolizumab (Keytruda) combined with pemetrexed and platinum chemotherapy, NICE estimates.

The drug is recommended for adults with untreated non-small-cell lung cancer, whose tumours have no epidermal growth factor receptor (EGFR)- or anaplastic lymphoma kinase (ALK)-positive mutations.

Pembrolizumab targets a specific protein on the surface of cells which is involved in the body’s immune response to cancer.

Manufacturers, MSD, reported that in a clinical trial, this pembrolizumab combination therapy gave patients nearly four additional months without their cancer progressing, compared with standard treatment of pemetrexed with platinum chemotherapy.

As further evidence is needed on the benefits of the combination therapy, NICE said the drug could not be considered for routine NHS use. But NICE recognised that it has the potential to be cost effective, and was likely to extend life, making it eligible for use on the CDF.

Under a CDF managed access agreement, MSD will continue to collect data on the treatment’s effectiveness until June 2019, after which there will be a further review of this guidance.

The treatment, which individual patients can receive for a maximum of two years, will continue to be available during this review.

Meindert Boysen, director of the NICE Centre for Health Technology Evaluation, said: "Over the past two decades there have been few improvements for people with this type of lung cancer so we are pleased to support access to this new option via the Cancer Drugs Fund, and keen to see further data on its effectiveness as it becomes available."

Professor Charles Swanton, Cancer Research UK’s chief clinician, said: “This decision is good news for people affected by this type of lung cancer. This drug combination has shown significant benefits for some patients in clinical trials, helping them to survive their cancer for longer.

"This also shows the value of the Cancer Drugs Fund, which gives NICE the option to approve promising treatments while more data is collected on their long-term benefits. Lung cancer is the biggest cancer killer in the UK so it’s vital that innovations like this reach patients as quickly as possible."

John Stewart, NHS England’s director of specialised commissioning, said: “NHS England has worked closely with MSD to reach a commercial deal to make this innovative drug available to a new group of lung cancer patients. This is another example of how a more flexible approach to price negotiation has clear benefits – not only for patients, but also for industry and taxpayers.”

This combination therapy will be available to NHS patients in England immediately. Subject to appeal, NICE’s final guidance will be published in January, eight months after the appraisal began.

Pembrolizumab is administered every three weeks by intravenous infusion. The 200 mg infusion has a list price of £5260, but the company has offered the NHS a confidential discount.

NICE is also developing guidance on its use for various other indications, including a Cancer Drugs Fund recommendation for its use for melanoma.

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