Some patients with lung cancer will be able to receive an immunotherapy drug with standard chemotherapy on the NHS in England.
Pembrolizumab (Keytruda) can now be used with standard chemotherapy drugs, pemetrexed and platinum chemotherapy, to treat certain patients with a type of lung cancer called non small cell lung cancer.
Draft guidance from the National Institute for Health and Care Excellence (NICE) says patients with this type of cancer will be eligible for the combined treatment if they have tumours that don’t carry gene faults that can be treated with certain targeted drugs.
A phase 3 clinical trial, published in May this year, showed that combining this immunotherapy with chemotherapy significantly boosted survival for these patients. Side effects from the combination treatment were similar to those in patients treated with just the chemotherapy drugs.
NICE recognised that the treatment option could be cost-effective, but said more evidence was needed on the drug’s effectiveness before it can be made routinely available. As a result, the immunotherapy drug will initially be made available via the Cancer Drugs Fund, while more data is collected on how well it works.
Cancer Research UK’s chief clinician, Professor Charles Swanton, called the decision “good news for people affected by this type of lung cancer”.
Promising clinical trial results
According to Merck, Sharpe & Dohme (MSD), the company that makes the pembrolizumab, results from a clinical trial show that around 69 out of 100 patients who received pembrolizumab with pemetrexed and platinum chemotherapywere alive 12 months from starting treatment, compared to 49 in 100 on standard treatment alone.
Out of the 616 patients who took part in the trial, 405 took the drug combination and 202 just had chemotherapy. Side effects were similar in both groups, the most common being nausea and tiredness.
“This drug combination has shown significant benefits for some patients in clinical trials, helping them to survive their cancer for longer,” said Swanton.
NICE estimates that more than 3,000 patients in England may be eligible for this treatment.
The Cancer Drugs Fund allows patients to access treatments before they are fully approved for use in the NHS. This gives the NHS and the drug company time to collect more data on the long-term benefits of the drug.
The company has also agreed a discounted price.
Swanton said this decision shows the value of the Cancer Drugs Fund, which was redesigned in 2016 to speed up access to promising new treatments.
“Lung cancer is the biggest cancer killer in the UK so it’s vital that innovations like this reach patients as quickly as possible,” he said.
NICE plan to review this new addition to the Cancer Drugs Fund next year.
Another option for people with this type of lung cancer is taking pembrolizumab alone, which was made available in June this year in cases where the disease had already spread, and lab tests suggested the immunotherapy might work.