Three new treatment options approved for NHS use in Scotland

The Scottish Medicines Consortium (SMC) has accepted 3 new cancer treatments for NHS use in Scotland.

The latest batch of decisions includes:

• the targeted ovarian cancer drug, rucaparib (Rubraca)
• an immunotherapy for leukaemia, blinatumomab (Blincyto);
• and a targeted drug for some adults with lung cancer, lorlatinib (Lorviqua).   

Rucaparib can now be used to extend the effects of initial treatment for adults with advanced ovarian and gynaecological cancers of the fallopian tube or peritoneum.

“Clinical trial evidence suggests rucaparib can give patients more time before their cancer gets significantly bigger,” said Slack.

People whose tumours have mutations that affect DNA repair, including BRCA faults, lived without their cancer getting bigger for 13.6 months on average after taking rucaparib.

Although the trial included people whose tumours contained BRCA mutations, NHS patients will only be eligible for the drug if their cancer has previously responded to platinum-based chemotherapy and do not test positive for a faulty version of the BRCA gene.

The decision follows on from rucaparib’s approval for NHS use in England last year, alongside another PARP inhibitor – olaparib (Lynparza). Both drugs kill cancer cells by tampering with their ability to repair DNA.

“It’s great to hear that some women in Scotland with these types of recurrent cancers will now have access to rucaparib – a drug developed by our scientists in the 1990s in collaboration with industry partners,” said Slack.

Blinatumomab bridging the leukaemia gap

In a second SMC decision, blinatumomab was approved for some adults with a specific type of acute lymphoblastic leukaemia called Philadelphia negative leukaemia.

Blinatumomab works by creating a “bridge” between immune cells and cancer, helping immune cells to kill the leukaemia cells. The decision means that for patients who may still have a small number of cancer cells after treatment, but not enough to be picked up in standard tests, blinatumomab will the next step in treating the disease.

“This decision is a positive step, as people with this type of blood cancer don’t have many other treatment options if their initial chemotherapy hasn’t cleared all of the disease” added Slack.

This drug has previously been approved for use in England. Clinical trial evidence suggests blinatumomab could give patients more time before their cancer returns, as well as potentially improving their quality of life.

Lung cancer looks to lorlatinib

The SMC approval of lorlatinib comes after an initial decision by the National Institute for Health and Care Excellence (NICE) to reject the drug for NHS use in England earlier this year.

The targeted cancer therapy provides a new treatment option for adults whose non small cell lung cancer tests positive for a fault in the ALK gene whose and has progressed after initial chemotherapy. Between 3 and 5 in 100 people with non small cell lung cancer have a change in the ALK gene.

“Patients told the SMC that for this type of lung cancer, there was an unmet need for new treatment options” said Slack.

Lorlatinib is a type of cancer growth blocker known as a tyrosine kinase inhibitor. It blocks certain chemical messengers that tell cells to grow.

In early clinical trials, around 4 in 10 people’s cancers shrunk or disappeared in response to the treatment. But as there is limited data comparing the drug to existing chemotherapy options, lorlatinib has been accepted for NHS use on an interim basis, with the decision due to be reviewed once more data on the drug’s long-term benefits for patients becomes available.

Slack pointed out that “compared to current chemotherapy-based options, clinicians suggested lorlatinib could improve patients’ treatment outcomes and quality of life. It’s welcome news that the drug will now be available to patients in Scotland.”