Faster access to cancer drugs

Patients getting faster access to cancer drugs as NICE approves three quarters of the Cancer Drugs Fund | NICE

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Liver cancer drug, sorafenib has been approved for routine NHS use, marking three quarters of the way through the Cancer Drugs Fund (CDF) without a negative decision.

NICE has recommended sorafenib, also known as Nexavar, made by Bayer to be routinely available for some patients on the NHS.

Sorafenib is one of the 24 drugs NICE was asked to appraise from the CDF, and all have been approved so far for routine NHS use.

Its positive recommendation means that NICE is three quarters of the way through the CDF with 18 drugs now approved.

Companies, like Bayer have provided discounts and in some cases additional evidence meaning the drugs can be considered as cost effective for routine NHS.

Read the full news story here

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NICE set to approve trastuzumab emtansine for breast cancer

The NHS in England will soon be able to routinely fund the use of trastuzumab emtansine for people with certain categories of breast cancer, the National Institute for Health and Care Excellence (NICE) has announced in new draft guidance | OnMedica

NICE’s decision means that, by late summer, more than a thousand women and men could benefit from the drug.

HER2-positive breast cancer accounts for about a fifth of the roughly 41,500 women and 300 men who are diagnosed with breast cancer each year in England, but HER2-positive tumours are typically more aggressive than other types of breast cancer. The targeted treatment trastuzumab (Herceptin) is only effective for this type of breast cancer. Trastuzumab emtansine (Kadcyla) is licensed for the treatment of locally advanced or metastatic HER2-positive breast cancer, after trastuzumab and a taxane, taken either in combination or separately.

Currently, trastuzumab emtansine – which at full list price costs about £90,000 per patient – is only available on the NHS through the Cancer Drugs Fund (CDF). But NICE revealed yesterday afternoon that the drug’s manufacturer Roche had agreed a new commercial access arrangement with NHS England. When NICE factored this confidential agreement into a new clinical and cost-effectiveness analysis, also applying end-of-life criteria, it concluded that it can now recommend the drug as cost effective for routine use on the NHS.

NICE Quality Standard: Haematological cancers

NICE has published a new quality standard Haematological cancers (QS150).

This quality standard covers diagnostic reporting and the organisation of haematological cancer services for people of all ages (including children and young people) and managing haematological cancers in adults and young people (aged 16 and over). It describes high-quality care in priority areas for improvement.

Cancer experts condemn cancer drug decision

Expert cancer clinicians have condemned a preliminary decision by the National Institute for Health and Care Excellence (NICE) not to approve use of the drug nivolumab (Opdivo) for the treatment of head and neck cancer on the NHS | OnMedica

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NICE has today issued new draft guidance which does not recommend nivolumab in this way, saying that it is not cost-effective.

Nivolumab is administered intravenously every two weeks and the drug works by blocking a protein on the surface of cells known as PD-L1, which reduces the activity of the body’s immune cells. There is more PD-L1 on cancerous cells which stops the immune system from attacking the tumour.

NICE said the anticipated marketing authorisation for nivolumab was for treating squamous cell carcinoma of the head and neck which has progressed during or after platinum-based chemotherapy.

The watchdog found that the evidence showed a significant improvement in overall survival rates in the short term after nivolumab. However, its value for money was considerably above that which is usually a cost-effective use of NHS resources.

Read the full commentary here

NICE draft guidance is available here

NICE: All patients with colorectal cancer should be tested for genetic condition

Everyone who has colorectal cancer diagnosed should be tested for an inherited genetic condition called Lynch syndrome, new guidance states | BMJ

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The National Institute for Health and Care Excellence (NICE) recommends microsatellite instability testing or immunohistochemistry to detect abnormalities that may indicate the syndrome.

Lynch syndrome, the most common cause of hereditary bowel cancer, has also been linked to an increased risk of developing other cancers including womb, ovarian, and stomach. People with the condition who develop colorectal cancer generally do so at a younger age, usually 40-50.

Testing for the condition helps to identify whether the patient’s family are also at increased risk of cancer so that they can be monitored more closely if needed, says NICE. Where these tests show that a person has a risk of the syndrome, the guidance recommends further tests to confirm the diagnosis. Because it is an inherited condition, a positive test can also lead to testing of family members.

Diagnosing Lynch syndrome may also help with the choice of treatment for colorectal cancer—for example, to direct chemotherapy or surgery.

Read the full overview here

Read the full guidance recommendations here

Treatment of head and neck cancer

NICE prioritises four areas of head and neck cancer care for improvement.

NICE is consulting on a new draft quality standard to improve treatment of head and neck cancer that could prevent 250 people a year undergoing major surgery which is of no benefit.

Currently when scans can’t detect if cancer has spread to the lymph nodes in patients with early oral cavity cancer, the lymph nodes are surgically removed as a precaution.

The draft quality standard recommends those patients instead have a biopsy to remove the main lymph gland linked to the cancer to establish if it has spread and if further surgery is needed.

Two drugs set to be removed from the Cancer Drugs Fund

OnMedica | Published online: 18 August 2016

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The National Institute for Health and Care Excellence has issued draft guidance recommending that two drugs are removed from the Cancer Drugs Fund because they are not cost effective. The drugs, everolimus (Afinitor made by Novartis) for breast cancer and ibrutinib (Imbruvica, Janssen) for mantle cell lymphoma are being appraised under the new CDF system. The ultimate decision on whether the drugs will be removed will rest with NHS England

Under the new CDF system as a gateway fund for new cancer drugs, NICE recommends drugs are funded through the CDF if there is not enough information to make an immediate decision on whether they should be available on the NHS to enable patients to access the drugs while the company generates the supporting information required.

NICE rejected everolimus (in combination with the drug exemestane) for treating HER2-negative, hormone-receptor-positive advanced breast cancer in 2013 and it was then made available through the CDF.

Read the full news story here