Ovarian, bowel and non-Hodgkin’s lymphoma treatments approved for NHS use in Scotland
Three new treatment options will be made available for patients in Scotland living with advanced ovarian cancer, bowel cancer and a rare form of non-Hodgkin’s lymphoma.
The latest batch of drug decisions from The Scottish Medicines Consortium (SMC) includes the approval of olaparib, nivolumab and ibrutinib for use on the NHS in Scotland.
David Ferguson, public affairs manager for Cancer Research UK in Scotland hopes the decisions will give patients facing these advanced forms of cancer “better options for treatment and more memories with the people they love.”
Targeted cancer drug made available for advanced ovarian cancer
Olaparib (Lynparza) is a type of targeted cancer treatment that blocks an enzyme called PARP from working. Without PARP, it’s more difficult for cancer cells to repair, making them more likely to die.
In a phase 3 study, olaparib was used in combination with bevacizumab to prolong the effects of initial treatment for people with advanced ovarian cancer. The SMC decision declared that olaparib plus bevacizumab gave patients longer without their cancer growing, compared to a placebo plus bevacizumab.
The treatment will be offered to adults with advanced, high-grade epithelial ovarian, fallopian tube or primary peritoneal cancer, who have already been treated with chemotherapy and bevacizumab.
It will only be an option if someone’s cancer has genetic changes that prevent cells from repair DNA damage – such as a fault in BRCA1 and BRCA2 genes, or genomic instability.
Ferguson said: “Cancer Research UK played a leading role in the first clinical trials for olaparib, which led to it being used routinely to treat ovarian cancer in patients who have the BRCA1 and BRCA2 gene faults.
“Olaparib is now a well-established treatment option for ovarian cancer and today’s decision reaffirms that position for advanced ovarian cancer.”
Immunotherapy combo approved for people with bowel cancer
In a second decision, the SMC approved an immunotherapy combo for adults with bowel cancer that has spread to other parts of the body.
The new combination of nivolumab (Opvido) and ilipimumab will be offered to people whose cancers can be described as microsatellite instability-high (MSI-H) or mismatch repair deficient (dMMR) due to generic changes in the cells.
Right now, there’s limited data on whether the combination can increase survival compared with current treatments like chemotherapy. But results from a phase 2 clinical trial found that by the end of the trial, 65% of patients’ cancers responded to the treatment.
Patients reported an improved quality of life undergoing this treatment compared to chemotherapy, with fewer side effects and greater hope for potentially added months and years of life.
Current NHS treatment options for advanced bowel cancer are known to be extremely limited. “It’s great news for patients that nivolumab has been approved for further use in NHS Scotland,” Ferguson said.
“Nivolumab provides a more targeted approach to treating cancer, by helping the immune system to attack tumours. Studies in metastatic colorectal cancer have found that it can help some patients live longer, as well as producing fewer side effects than other treatments.”
A new treatment option for patients with a rare type of non-Hodgkin’s lymphoma
In the final SMC cancer decision of the month, drug that blocks cancer from growing, called ibrutinib (Imbruvica) has been accepted for use with patients diagnosed with Waldenström’s macroglobulinaemia (WM).
The drug will provide a vital new option for patients who’ve already had at least one cancer treatment – which tends to be chemotherapy in combination with immunotherapy – or people who are unable to take this combination.
Right now, the only available option for people at this stage is a combination of ibrutinib plus another drug called rituximab. A combo that’s not suitable for everyone.
Having the option to take ibrutinib by itself represents a “major step change” for those diagnosed with WM. And, as an oral treatment, it reduces the need for frequent hospital visits.
Ferguson added the treatment has “shown great promise in clinical trials with patients whose cancer has come back after previous treatment, helping to keep cancer at bay for longer.”
All 3 decisions apply to NHS Scotland only, with England, Wales and Northern Ireland having a separate process for reviewing treatments.
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