Potentially life-extending treatment for lung cancer available in England

A potentially life-extending treatment for some people with non small cell lung cancer (NSCLC) will now be available on the NHS in England, following its draft approval by the National Institute of Health and Care Excellence (NICE).

The decision means that the immunotherapy drug pembrolizumab (Keytruda), in combination with pemetrexed and platinum chemotherapy, will continue to be an option for adults with untreated, non-squamous NSCLC that’s spread to other parts of the body. The combination was previously available to people in England through the Cancer Drugs Fund, which gives people access to innovative treatment while more data is collected on their long-term benefits.

NICE estimates that around 3,000 people will be eligible for the treatment in England. The treatment will only be an option for people whose tumours don’t test positive for mutations in one of two genes that make cancer cells grow and divide – either epidermal growth factor receptor (EGFR) or anaplastic lymphoma kinase (ALK).

Extending its reach

Pembrolizumab is an immunotherapy that aims to boost the immune system’s ability to recognise and kill cancer cells. It works by blocking a molecule found on immune cells – called PD-1 – from talking to cancer cells. Last year, the drug was approved for use in England for some cancers, but this depended on whether or not tumours tested positive for a protein known as PD-L1.

The new guidance means that people with NSCLC will now be eligible to take pembrolizumab for up to 2 years, regardless of their PD-L1 status.

“As well as helping 200,000 people begin cancer care since the start of the pandemic and delivering more than 389,000 cancer treatments throughout the coronavirus pandemic, the NHS has been working to bring in new treatments that offer the best care. This is the latest deal that the NHS has struck to help hundreds of patients every year, who will now be able to have this immunotherapy as an option for their lung cancer.” – Professor Peter Johnson, NHS National Clinical Director for Cancer

Although there’s no data directly comparing the pembrolizumab combination treatment with pembrolizumab monotherapy, clinical data suggests that patients treated with the combination treatment for up to 2 years are likely to live longer than those who have the standard chemotherapy.

NICE decisions are usually adopted in Wales and Northern Ireland. Scotland has a separate process for reviewing drugs.

NICE (2020) Pembrolizumab with pemetrexed and platinum-based chemotherapy for untreated non-small-cell lung cancer [ID1584]