NICE | March 2019 | Promising lung cancer treatment approved for Cancer Drugs Fund
NICE has unveiled a promising lung cancer treatment has been approved for the Cancer Drugs Fund, as a result of a NICE recommendation. Today NICE has published draft final guidance.
Durvalumab helps the body’s immune system to find and attack cancer cells, by blocking the PD-L1 protein which disguises cancer.
In a clinical trial people taking it went for an average of around 2 years without the disease progressing, versus 6 months for those without. The committee agreed that it was plausible that between 27% and 40% of people taking durvalumab would have 5 years of progression-free survival.
The draft guidance is available from NICE
Read the full details from NICE
NICE Lung cancer: diagnosis and management
University of Newcastle Promising lung cancer treatment available on the NHS
University of Birmingham | June 2018 | Trial to test new treatment combination for children and adults with Leukaemia
A clinical trial testing a new treatment combination in patients with leukaemia launches through the Combinations Alliance, a joint initiative between Cancer Research UK and the Experimental Cancer Medicine Centres (ECMC) Network based at University of Birmingham.
Researchers want to discover whether pharmaceutical companies AstraZeneca and MSD’s experimental medicine, selumetinib (AZD6244, ARRY-142886), can be effective in combination with a treatment, dexamethasone, already used for several conditions including leukaemia.
This clinical trial, the first of its kind to include both adults and children is based at the Cancer Research UK Clinical Trials Unit at the University of Birmingham. This trial is planned to open in 23 centres throughout the UK and in 11 additional centres in 6 European countries, to help recruit 42 patients.
Professor Josef Vormoor, international clinical lead for the trial, said: ‘Although there are effective treatments for leukaemia, for some patients, the disease can return after they have been treated. If this combination is successful, it could give us an urgently needed new way to treat patients who have relapsed and have few treatment options left.’ (Source:University of Birmingham)
The full press release can be read at the University of Birmingham’s website
Further details on the clinical trial are available from Cancer Research
NHS England | June 2018 | NHS England strikes deal on new NICE recommended lung cancer immunotherapy drug
NHS England have announced it will make lung cancer drug pembrolizumab available for routine use on the NHS. Trial results show pembrolizumab extends life for certain adults with lung cancer for more than a year.
According to NHS England Pembrolizumab is the first drug to exceed the new budget impact threshold for new products costing more than £20 million a year. The drug, which is also called Keytruda, would have cost around £84,000 per patient at its full list price. NHS England and MSD have agreed a confidential arrangement for reimbursement which will enable NICE to recommend it be routinely available on the NHS (NHS England).
The full announcement is available at NHS England
University of Leeds | April 2018 |Women at increased cancer risk shun preventative tamoxifen therapy
A study published in Breast Cancer Research and Treatment shows that only 1 in 7 women who were offered Tamoxifen due to a familial history of cancer decided to take it. This new research sought to highlight that women eligible to take the drug were electing not to, it also aimed to explore the reasons behind such decisions. Researchers also found that patients consulted informal networks such as friends and family before making a decision about whether to take Tamoxifen (via University of Leeds) .
Whether the participants had children also had an impact on the decision, the scientists found those with children were more likely to take the drug. One participant explained that taking the drug might affect her ability to care for her children and parents, so decided not to take it.
The study was conducted in collaboration with scientists at the University Hospitals Southampton, University College London, Queen Mary University, University of Leeds and Northwestern University. The research was funded by Cancer Research UK and Yorkshire Cancer Research.
Purpose Uptake of preventive therapy for women at increased breast cancer risk in England is unknown following the introduction of UK clinical guidelines in 2013. Preventive therapy could create socioeconomic inequalities in cancer incidence if it is more readily accepted by particular socio-demographic groups. In this multicentre study, we investigated uptake of tamoxifen and evaluated socio-demographic and clinical factors associated with initiation. We explored women’s experiences of treatment decision-making using qualitative interview data.
Methods Between September 2015 and December 2016, women (n=732) attending an appointment at one of 20 centres in England to discuss breast cancer risk were approached to complete a survey containing socio-demographic details and nul-
liparity. Of the baseline survey respondents (n equal to 408/732, 55.7% response rate), self-reported uptake of tamoxifen at 3-month follow-up was reported in 258 (63.2%). Sixteen women participated in semi-structured interviews.
Results One in seven (38/258=14.7%) women initiated tamoxifen. Women who had children were more likely to report use of tamoxifen than those without children (OR=5.26; 95%CI: 1.13–24.49, p=0.035). Interview data suggested that women weigh up risks and benefits of tamoxifen within the context of familial commitments, with exposure to significant other’s beliefs and experiences of cancer and medication a basis for their decision.
Conclusions Uptake of tamoxifen is low in clinical practice. There were no socio-demographic differences in uptake, suggesting that the introduction of breast cancer preventive therapy is unlikely to create socioeconomic inequalities in cancer incidence. Women’s decision-making was influenced by familial priorities, particularly having children.
The full article can be downloaded here
Since the Cancer Drugs Fund (CDF) opened in July 2016, nearly 15,700 patients have benefited from 52 drugs treating 81 different types of cancer. Of these patients, around 5,000 have received treatment sooner than they would have under the previous system.
AS NHS England has also secured discounts on on eight of the treatments previously funded via the old CDF this is expected to generate savings for the NHS of around £140m over the next five years.
The new system means the National Institute for Health and Care Excellence (NICE) appraisal process now starts much earlier for newly referred drugs, with the aim of publishing draft guidance before drugs receive their licence, and then final guidance to be issued within 90 days of that.
Patients also benefit from new cancer drugs at least four months earlier under the reformed CDF than was previously the case. All cancer treatments recommended by NICE, whether for routine commissioning or the CDF are now available to patients as soon as positive draft guidance is published by NICE.
Further information can be found at NHS England
NICE confirms that it will recommend that breakthrough cancer drugs palbociclib and ribociclib be provided on the NHS for women with advanced breast cancer| story via OnMedica
There are around 45,000 new diagnosis of breast cancer each year in England and it is estimated that around 8,000 of these people would be eligible for treatment with either palbociclib or ribociclib.
In draft guidance, NICE said breast cancer patients should have routine access to these two life extending drugs after a new deal with their manufacturing companies who agreed to lower the price and who gave more evidence for their effectiveness.
Palbociclib (Ibrance) from Pfizer and ribociclib (Kisqali) from Norvatis, are recommended for people with hormone receptor (HR) positive, HER2 negative locally advanced or secondary breast cancer.
NICE said that although there were some uncertainties on how long they extend the life expectancy of people with this type of breast cancer, these promising new drugs were found to stall the growth of cancer for an extra 10 months on average.
Cancer Research UK launches trial to test new drug in patients with advanced cancer | Cancer Research UK
A clinical trial to test a new cancer drug in patients with advanced solid tumours, launches in four centres across the UK, through Cancer Research UK’s Centre for Drug Development.
This early phase trial will test the safety and tolerability of the drug and establish the recommended dose for patients with a variety of cancers including advanced bowel, lung, ovarian, urothelial, pancreatic, breast, head and neck, and oesophageal cancer.
In the first part of the trial, groups of patients will receive increasing doses of the drug, called LY3143921 hydrate, to find the safest dose that best targets the cancer cells. The drug, discovered by Eli Lilly, was brought to Cancer Research UK through the charity’s Clinical Development Partnership scheme.
In the second part, larger groups of patients will receive the highest tolerated dose, so that researchers can investigate how the drug is working on the cancer cells.
The drug has not yet been tested in people but has shown promise in mice by selectively inhibiting Cdc7, a protein that helps cells to reproduce correctly.
Full story at Cancer Research UK