NICE: Cancer patients to benefit from new histology independent treatment

NICE | July 2020 | Cancer patients to benefit from new histology independent treatment

Entrectinib (Rozlytrek, Roche), a revolutionary treatment for a range of cancers, is the second histology independent drug to be recommended by NICE for use on the Cancer Drugs Fund (CDF).

As a histology independent treatment, entrectinib targets all solid tumours that have a certain genetic mutation (a neurotrophic tyrosine receptor kinase (NTRK) gene fusion), regardless of where the cancer originated in the body.

This is particularly beneficial to patients with some rare types of cancer where the treatments are currently limited.

The final draft decision is set to benefit adults and children 12 years and older, with advanced NTRK fusion-positive solid tumours, who have no satisfactory treatment options. Eligible patients will have access to entrectinib through the CDF once the marketing authorisation has been granted.

Further information available from NICE

NICE recommends treatment for type of small-cell lung cancer

NICE  |  May 2020 | NICE recommends treatment for type of small-cell lung cancer

A new treatment option for patients with extensive-stage small-cell lung cancer has been approved by NICE.

In new draft guidance, atezolizumab (also called Tecentriq and made by Roche) with carboplatin and etoposide has been recommended as an option for untreated extensive-stage small-cell lung cancer (ES-SCLC).

Around 2400 people in England have ES-SCLC, of whom around 1200 people will be eligible for treatment with atezolizumab with carboplatin and etoposide.

The positive recommendation follows consultation on NICE’s previous draft guidance which did not recommend the treatment. The company has since agreed on a new price for atezolizumab with NHS England and Improvement, which means that the treatment is now considered a cost-effective use of NHS resources.

The clinical trial evidence for the combination treatment was based on patients with an Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1. Clinical experts suggested that the effects of the treatment may be different for people with a score of 2 or higher, that is, a more severe illness, so atezolizumab with carboplatin and etoposide was recommended only for patients with an ECOG performance status of 0 or 1.

Meindert Boysen, deputy chief executive officer and director of the Centre for Health Technology Evaluation at NICE, said: “We are pleased to be able to recommend this new treatment that could extend the life of patients with this type of lung cancer.

“I know how important this news will be for patients suffering with this condition, for which there are currently few treatment options. Atezolizumab with carboplatin and etoposide may offer valuable time for patients to spend with their loved ones.”

ES-SCLC is a form of lung cancer accounting for 1 in 8 lung cancer cases in the UK. It is an aggressive disease that progresses rapidly, with a significant negative impact on the quality of life of patients.

Clinical trial evidence suggests that atezolizumab with carboplatin and etoposide increases the time before the disease worsens by around 1 month compared with standard chemotherapy (5.2 months versus 4.3 months respectively).

It also suggests that atezolizumab plus carboplatin and etoposide increases overall survival compared with standard chemotherapy. However, the long-term benefit on overall survival was uncertain.

NICE expects to publish its final guidance on atezolizumab for ES-SCLC in June 2020 (Source: NICE)

Atezolizumab with carboplatin and etoposide for untreated extensive-stage small-cell lung cancer

NICE recommends atezolizumab for treating people with triple negative breast cancer

Improved deal means new treatment for a type of advanced breast cancer can be recommended by NICE

Draft guidance published by NICE recommends atezolizumab for treating people with a type of breast cancer, called triple negative breast cancer, that has spread to other parts of the body.

The positive recommendation follows consultation on NICE’s previous draft guidance which did not recommend atezolizumab. The company has agreed to provide a larger discount to the list price of the drug following a deal with NHS England & NHS Improvement.

Around 2000 people in England have triple negative breast cancer, of whom around 600 people would be eligible for treatment with atezolizumab and nab-paclitaxel.

Full detail at National Institute for Health & Care Excellence

NICE draft guidance recommends new treatment option for people with early breast cancer

NICE  |  May 2020  | NICE draft guidance recommends new treatment option for people with early breast cancer

NICE published draft guidance which recommends trastuzumab emtansine (also called Kadcyla and made by Roche) as an option for some people with HER2-positive early breast cancer.

Around 7000 people diagnosed each year in England with early breast cancer have HER2-positive disease. HER2, which stands for human epidermal growth factor receptor 2, is a protein on the surface of cancer cells which makes them grow and divide.

Trastuzumab emtansine is a type of targeted cancer drug. Trastuzumab attaches to the HER2 receptor allowing the emtansine to go into the cancer cell where it becomes active and kills the cancer cell.

Clinical trial evidence shows that in people who still have some cancer cells remaining after chemotherapy to shrink their tumour and HER2-targeted treatment, trastuzumab emtansine increases the time people remain free of disease compared with trastuzumab alone. It is not known if trastuzumab emtansine increases the length of time people live because the final trial results are not yet available.

NICE NICE draft guidance recommends new treatment option for people with early breast cancer

[NICE Technology Appraisal Guidance] Lenalidomide with rituximab for previously treated follicular lymphoma

NICE | April 2020 | Lenalidomide with rituximab for previously treated follicular lymphoma |Technology appraisal guidance [TA627]

NICE has produced evidence-based recommendations on lenalidomide (Revlimid) with rituximab for previously treated follicular lymphoma (grade 1 to 3A) in adults.

Full details form NICE 

Lenalidomide with rituximab for previously treated follicular lymphoma

NICE Guideline: COVID-19 rapid guideline: delivery of systemic anticancer treatments

NICE | March  2020 |COVID-19 rapid guideline: delivery of systemic anticancer treatments

NICE guideline [NG161]

The purpose of this guideline is to maximise the safety of patients with cancer and make the best use of NHS resources, while protecting staff from infection. It will also enable services to match the capacity for cancer treatment to patient needs if services become limited because of the COVID-19 pandemic.

On 3 April 2020, NICE added 2 recommendations on when to offer and continue systemic anticancer treatment for patients with COVID-19. NICE also amended the table on prioritising treatments in line with new advice from NHS England.

 

This guideline is for:

  • health and care practitioners
  • health and care staff involved in planning and delivering services
  • commissioners

Further information availlable from NICE 

NICE has also produced a COVID-19 rapid guideline on delivery of radiotherapy.

COVID-19 rapid guideline: delivery of radiotherapy NICE guideline

NICE |  March 2020 | COVID-19 rapid guideline: delivery of radiotherapy [NG162]

The purpose of this guideline is to maximise the safety of patients who need radiotherapy and make the best use of NHS resources, while protecting staff from infection. It will also enable services to match the capacity for radiotherapy to patient needs if services become limited because of the COVID-19 pandemic.

This guidance was first published on 28 March 2020.

NICE has also produced a COVID-19 rapid guideline on delivery of systemic anticancer treatments.

This guideline is for:

  • health and care practitioners
  • health and care staff involved in planning and delivering services
  • commissioners

The recommendations bring together

  • existing national and international guidance and policies
  • advice from specialists working in the NHS from across the UK. These include people with expertise and experience of treating patients for the specific health conditions covered by the guidance during the current COVID-19 pandemic.

Full details from NICE

[NICE Consultation] Brain tumours (primary) and brain metastases in adults

NICE |  March 2020 | Brain tumours (primary) and brain metastases in adults | In development [GID-QS10092]

NICE has released a consultation for the 5 key areas for quality improvement which you consider as having the greatest potential to improve the quality of care in this area. 

Closing date for comments: Monday 20 April 2020 at 5pm

Full details from NICE

Colorectal cancer

Colorectal cancer | NICE guideline [NG151] | January 2020

This guideline covers managing colorectal (bowel) cancer in people aged 18 and over. It aims to improve quality of life and survival for adults with colorectal cancer through management of local disease and management of secondary tumours (metastatic disease).

Recommendations

This guideline includes recommendations on:

See also: Colorectal cancer (Quality Standard 20, updated from Aug 2012)