A targeted cancer drug for advanced ovarian cancer will be more widely available for certain patients on the NHS in England.
Olaparib (Lynparza) is recommended as a way to prolong the effects of initial treatment, so called maintenance therapy.
The decision by the National Institute for Health and Care Excellence (NICE) means the drug will now be available much earlier on in a patient’s treatment plan, a move that could help people live longer and halt the progression of their disease.
The extension of olaparib treatment will be paid for through the Cancer Drugs Fund (CDF). It covers patients diagnosed with advanced ovarian cancer and gynaecological cancers of the fallopian tube and the tissue layer covering the stomach (peritoneum).
Patients will be eligible for the drug if their cancers test positive for a faulty version of the BRCA gene and have previously responded to platinum-based chemotherapy.
NICE expects around 700 patients a year could benefit from the treatment.
Cancer Research UK’s policy manager, Rose Gray, said this was “fantastic news.”
“Patients and clinicians told NICE there is a real need for new treatments for this cancer type, and that using olaparib earlier in patients’ treatment could mean the drug offers greater benefit.”
Earlier in treatment pathway
Patients have previously only had access to olaparib after they’ve taken three different chemotherapy drugs. They will now be offered the treatment after their first round of chemo.
Gray said Cancer Research UK research played a key role in the development of the drug, and NICE’s decision “will offer new hope” to some people affected by these diseases.
Under the terms of the decision, patients will be able to take olaparib for up to two years. They will be able to take the drug for longer if their cancer can still be detected and doctors think they are still likely to benefit from it.
Further data on drug’s long-term effects needed
The recommendation was based on preliminary trial results that suggests olaparib can delay the time before these cancers get worse, compared to a dummy drug (placebo).
Out of the 391 people on the trial, those taking the dummy drug lived for an average of 13.8 months, whereas 60 out of 100 of those taking olaparib are still alive.
Dr Susana Banerjee, consultant medical oncologist at The Royal Marsden Hospital who was involved in the trial said maintenance treatment with olaparib “heralds a new era for women with ovarian cancer”.
“This is the first time we have seen such dramatic improvements in progression-free survival. This means that more women will have a longer time before relapse, time of chemotherapy and the possibility of increased survival.”
Because the trial is still in progress the drug’s potential to extend patients’ lives has not yet been fully assessed. But NICE said that if olaparib does increase overall survival it has the potential to be a cost effective use of NHS budgets.
“Because it’s been recommended for the Cancer Drugs Fund, patients will be able to access the drug while more evidence is gathered on its longer-term benefits,” says Gray.
Drugs recommended for the Cancer Drugs Fund in England are usually funded by the NHS in Wales and Northern Ireland too, so the drug should also be available there. Decisions about what drugs the NHS should fund in Scotland are made separately by the Scottish Medicines Consortium.
A cancer growth blocker
Olaparib stops cancer cells growing by halting the activity of a molecule called PARP.
Cancer cells carrying faulty a BRCA gene become dependent on PARP to help the cells repair damage to their DNA. When olaparib stops PARP from repairing DNA damage, the cancer cells die.
Moore, K et al. (2018) Maintenance Olaparib in Patients with Newly Diagnosed Advanced Ovarian Cancer. N Engl J Med DOI: 10.1056/NEJMoa1810858