Hundreds of people diagnosed with cancer early through life-saving NHS lung checks

NHS England | 19 April 2022 | Hundreds of people diagnosed with cancer early through life-saving NHS lung checks

Hundreds of people have been diagnosed with lung cancer earlier through NHS mobile trucks, as part of the biggest programme to improve early lung cancer diagnosis in health service history.

Today, NHS cancer chiefs are urging those most at risk of lung cancer to come forward as soon as they are invited for a life-saving health check, to help even more people benefit from early diagnosis.

The call comes as new figures show only a third (35 per cent) of patients go to their lung health check when invited by the NHS.

A further 20 NHS lung truck sites are due to go live shortly with the capacity to invite 750,000 more people at increased risk for a check, in efforts to catch thousands more cancers at an earlier stage.

So far, the 23 existing truck sites have issued up to 25,000 invitations every month.

Hundreds of people diagnosed with cancer early through life-saving NHS lung checks

In the news

Guardian NHS urges people to attend vital lung cancer check-ups in England

Over 700 people a year could benefit from a new potentially life-extending lung cancer drug which targets a specific genetic mutation

NICE | April 2022 | Over 700 people a year could benefit from a new potentially life-extending lung cancer drug which targets a specific genetic mutation

NICE has announced that a new treatment will be available for people with lung cancer. The innovative and potentially life-extending drug for treating people with a specific gene mutation of advanced non-small-cell lung cancer (NSCLC) has been recommended by NICE and will be available to patients from today (14 April 2022)

Full details are available from NICE

Further information about the project is available from NICE

Sheffield Research: Lung cancer drug could improve survival rates for bladder cancer patients undergoing chemotherapy

University of Sheffield | April 2022 | Lung cancer drug could improve survival rates for bladder cancer patients undergoing chemotherapy

Researchers found that adding nintedanib – a targeted cancer growth inhibitor currently used to treat non-small cell lung cancer – to chemotherapy, could significantly improve overall survival rate for bladder cancer patients.

• Phase two randomised placebo controlled trial (NEOBLADE) showed giving patients nintedanib, as well as chemotherapy before surgery or radiotherapy, significantly increased overall survival rates at one, two and five years
• Nintedanib belongs to a group of targeted therapy drugs known as cancer growth inhibitors which are already used to treat non-small cell lung cancer
• The inhibitor blocks different proteins from sending signals to the cancer cells to grow causing the cancer cells to die

UoS Lung cancer drug could improve survival rates for bladder cancer patients undergoing chemotherapy [news release]

Hundreds of patients to benefit from revolutionary lung cancer drug on the NHS

NHS England | March 2022 | Hundreds of patients to benefit from revolutionary lung cancer drug on the NHS

A revolutionary targeted drug for lung cancer will be made available to anyone who is eligible, thanks to a new drug deal, the head of the NHS announced earlier this month.

Sotorasib targets a genetic mutation, dubbed the ‘death star’, by medics and scientists, and has been proven during trials to prevent lung cancer from growing for seven months.

NHS patients in England were the first in Europe to benefit from the drug in September thanks to an early access agreement made with the manufacturer.

Around 100 patients have already received the treatment.

Announcing the new deal, Amanda Pritchard, NHS chief executive, said it meant even more patients could now benefit, with 600 people eligible for the ‘cutting edge’ drug every year.

Around one in eight lung cancer patients will have this lethal ‘death star’ mutation of the KRAS gene, so called because of its spherical appearance and impenetrable nature.

This first-of-its-kind treatment has taken more than four decades to develop and is the latest deal struck by the NHS as part of its Long Term Plan commitment to secure access to more innovative therapies.

The drug, which can be taken at home making it more convenient for patients, could also represent a major breakthrough in treatments for some of the world’s other deadliest cancers, including pancreatic and colorectal cancers.

It is also expected to offer a better and longer life than standard chemotherapy could, while also producing fewer side effects, boosting patients’ quality of life.

(Source: NHS England).

Full news story from NHS England

NICE: Over 600 people set to benefit from innovative lung cancer treatment within the Cancer Drugs Fund

NICE| November 2021 | Over 600 people set to benefit from innovative lung cancer treatment within the Cancer Drugs Fund

NICE has today (30 November) announced that more than 600 people are set to benefit from innovative lung cancer treatment within the Cancer Drugs Fund as NICE publishes its final draft guidance recommending osimertinib .

Osimertinib (also known as Tagrisso and made by AstraZeneca) is recommended for people with early-stage (1b to 3a) non-small-cell lung cancer (NSCLC) who have had surgery to remove their tumour and who have epidermal growth factor receptor (EGFR) gene mutations.

Current clinical trial evidence shows that compared with active monitoring, adjuvant treatment with osimertinib reduces the risk of the disease coming back by 80%. It may also lower the risk of dying from their cancer. However, this evidence is uncertain because information from the trial was released early, and the data is still immature. For this reason the drug is recommended for use within the CDF rather than in routine NHS commissioning.

The CDF recommendation means people with this form of lung cancer will be able to have osimertinib on the NHS while further evidence is gathered on its clinical and cost-effectiveness.

See NICE for full details
NICE Over 600 people set to benefit from innovative lung cancer treatment within the Cancer Drugs Fund [news release]

HSIB: Missed detection of lung cancer on chest X-rays of patients being seen in primary care

Healthcare Safety Investigation Branch | October 2021 | Missed detection of lung cancer on chest X-rays of patients being seen in primary care

The Healthcare Safety Investigation Branch‘s (HSIB) investigation reviewed the experience of a patient who saw their GP on multiple occasions and had three chest X-rays where the possible cancer was not identified. This resulted in an eight-month delay in diagnosis and potentially limited the patient’s treatment options.

Image is an x-ray of the lungs. Image source: HSIB

This investigation:

• Sought to nderstand the context and contributory factors influencing a delay in lung cancer diagnosis in a patient repeatedly attending primary care with non-specific symptoms.
• Identified the systemic factors that help or hinder the detection of lung cancer on chest X-rays.
• Considered the utility of chest X-ray to assess for lung cancer in symptomatic patients being seen in primary care.
• Identified the implications of the findings for mitigating the risk of delayed diagnosis of lung cancer.

The HSIB makes three recommendations as a result of this investigation, one to NHS England and NHS Improvement, one to the one to NHSX, and one to the National Institute for Health and Care Excellence. The HSIB expect a response to our safety recommendations within 90 days of publication of the investigation report. The responses will be shared here when it’s available.

The full investigation report is available from HSIB

NIHR: UK lung cancer trial shows screening at-risk groups lowers mortality rates

NIHR | September 2021 | UK lung cancer trial shows screening at-risk groups lowers mortality rates

This NIHR Alert summarises the findings of a piece of recent screening trial in the UK, the trial looked at the first lung cancer computed tomography (CT) screening trial in the UK.

This paper enhances our knowledge of lung cancer CT screening, including effects on mortality (lung cancer mortality and all-cause mortality), as well as on stage of the disease and on pulmonary nodule classification. As the UK lung cancer screening trial (UKLS) had only a single screen, this study adds considerably to knowledge of the pattern of lung cancer incidence and mortality post-screening. The associated meta-analysis, which includes the UKLS trial, provides the most up to date international view of lung cancer mortality in lung cancer CT screening studies (Source: Field et al, 2021).

NIHR UK lung cancer trial shows screening at-risk groups lowers mortality rates

Primary paper Lung cancer mortality reduction by LDCT screening: UKLS randomised trial results and international meta-analysis

International differences in lung cancer survival by sex, histological type and stage at diagnosis

Araghi, M.et al | 2021| International differences in lung cancer survival by sex, histological type and stage at diagnosis: an ICBP SURVMARK-2 Study| Thorax | Published Online First: 19 July 2021| doi: 10.1136/thoraxjnl-2020-216555

The authors of this study set out to answer the following research question: Are there international disparities in lung cancer survival by clinically relevant subgroups in the most recent population-level data?

In this paper, they present their in-depth results of the most up-to-date differences of lung cancer stage distribution and survival by histological types, age group and sex for each included country, as well as within countries, followed by a discussion of potential causes of the disparities including clinical and data factors.

Abstract

Introduction

 Lung cancer has a poor prognosis that varies internationally when assessed by the two major histological subgroups (non-small cell (NSCLC) and small cell (SCLC)).

Method

 236 114 NSCLC and 43 167 SCLC cases diagnosed during 2010–2014 in Australia, Canada, Denmark, Ireland, New Zealand, Norway and the UK were included in the analyses. One-year and 3-year age-standardised net survival (NS) was estimated by sex, histological type, stage and country.

Results

 One-year and 3-year NS was consistently higher for Canada and Norway, and lower for the UK, New Zealand and Ireland, irrespective of stage at diagnosis. Three-year NS for NSCLC ranged from 19.7 per cent for the UK to 27.1 per cent for Canada for men and was consistently higher for women (25.3% in the UK; 35.0% in Canada) partly because men were diagnosed at more advanced stages. International differences in survival for NSCLC were largest for regional stage and smallest at the advanced stage. For SCLC, 3-year NS also showed a clear female advantage with the highest being for Canada (13.8 per cent for women; 9.1 per cent for men) and Norway (12.8 per cent for women; 9.7 per cent for men).

Conclusion

 Distribution of stage at diagnosis among lung cancer cases differed by sex, histological subtype and country, which may partly explain observed survival differences. Yet, survival differences were also observed within stages, suggesting that quality of treatment, healthcare system factors and prevalence of comorbid conditions may also influence survival. Other possible explanations include differences in data collection practice, as well as differences in histological verification, staging and coding across jurisdictions.

Full paper is available from Thorax

[NICE Technology Appraisal Guidance] Nivolumab for advanced non-squamous non-small-cell lung cancer after chemotherapy

NICE | July 2021 | Nivolumab for advanced non-squamous non-small-cell lung cancer after chemotherapy

NICE has published technology appraisal guidance for Evidence-based recommendations on nivolumab (Opdivo) for advanced non-squamous non-small-cell lung cancer in adults after chemotherapy.

See NICE for full details

Nivolumab for advanced non-squamous non-small-cell lung cancer after chemotherapy

[NICE Technology Appraisal Guidance] Atezolizumab monotherapy for untreated advanced non-small-cell lung cancer

NICE |  02 June 2021 | Atezolizumab monotherapy for untreated advanced non-small-cell lung cancer

NICE has published its final guidance today , in which they’ve recommended atezolizumab as an option for some people with untreated metastatic non-small-cell lung cancer:

Evidence-based recommendations on atezolizumab (Tecentriq) for treating advanced non-small-cell lung cancer in adults. A table of NHS England interim treatment options gives possible alternative treatment options for use during the COVID-19 pandemic to reduce infection risk. This may affect decisions on using atezolizumab. See the COVID-19 rapid guideline: delivery of systemic anticancer treatments for more details.

Full details are available from NICE