Targeted breast cancer treatment approved for NHS use in England

Cancer Research UK | October 2019 | Targeted breast cancer treatment approved for NHS use in England

A new treatment for early stage breast cancer will be made available for certain patients on the NHS in England.

Following the recommendation from the National Institute for Health and Care Excellence (NICE), neratinib (Nerlynx) will be offered as an extended treatment for breast cancer patients who’ve had another targeted treatment, trastuzumab (Herceptin), within the last year.

cancer-icon-2797418_640.png

The new treatment is said to “significantly reduce the proportion of breast cancer relapses”, according to short-term trial data.

Neratinib blocks the cancer growth by interfering with chemical signals sent between cells.

It’s recommended for use for patients whose cancer tests positive for hormone receptors and a molecule called HER2. The treatment will only be available to adults who’ve been treated with trastuzumab within the last year, and where trastuzumab was used after initial treatment to help stop their cancer coming back.

This is the first treatment available for patients who have previously taken trastuzumab that maintain the intended effect of that treatment (adjuvant therapy).

Further criteria which patients will have to meet in order to access the drug include:

  • Trastuzumab is the only treatment they’ve taken that targets the molecule HER2
  • If trastuzumab was given before surgery, there were still signs of cancer in the tissue samples removed during surgery (Source: Cancer Research UK)

Read the press release from Cancer Research UK

Full details available from NICE 

Rucaparib for maintenance treatment of relapsed platinum-sensitive ovarian, fallopian tube or peritoneal cancer [ID1485]

NICE |  October 2019 | Rucaparib for maintenance treatment of relapsed platinum-sensitive ovarian, fallopian tube or peritoneal cancer [ID1485]

NICE has announced it has approved the medication for ovarian cancer- rucaparib-  can now be offered to women with relapsed ovarian, fallopian tube or peritoneal cancer, that has responded to platinum-based chemotherapy. Taken as a tablet, twice daily, it slows the progression of cancer by preventing cancer cells repairing so slowing down the tumour’s growth.

Around 1,350 people in England could benefit from this new treatment which will be available immediately through the CDF.

This approval is a change from the committee’s initial decision, where uncertainties in the evidence, and the price of rucaparib, meant it could not be recommended for routine use on the NHS.

Clinical trial evidence shows that rucaparib prevents cancer progression for twice as long as the placebo treatment (median of 10.8 months in the rucaparib group compared with 5.4 months in the placebo group). However, it is not known how this will translate into overall extended life expectancy due to incomplete trial data.

The drug company has since proposed an alternative price for rucaparib. If this revised commercial arrangement is supported with long-term overall survival data, rucaparib has the potential to be a cost-effective use of NHS resources. The committee therefore decided to include rucaparib in the CDF to allow this long-term data to be collected (Source: NICE).

The guidance is expected to be published on 13 November 2019.

Read the press release here

NICE Another treatment option for ovarian cancer approved for the Cancer Drugs Fund

In the news:

OnMedica Watchdog approves ovarian cancer treatment

Ribociclib with fulvestrant for treating hormone receptor-positive, HER2-negative, advanced breast cancer

NICE | August 2019 | Ribociclib with fulvestrant for treating hormone receptor-positive, HER2-negative, advanced breast cancer| Technology Appraisal Guidance

NICE has published Evidence-based recommendations on ribociclib (Kisqali) for hormone receptor-positive, human epidermal growth factor receptor 2 (HER2)-negative, locally advanced or metastatic breast cancer in adults who have had previous endocrine therapy.

Ribociclib with fulvestrant for treating hormone receptor-positive, HER2-negative, advanced breast cancer

See also:

Breast cancer drugs option joins cancer drugs fund

 

Olaparib for maintenance treatment of BRCA mutation-positive advanced ovarian, fallopian tube or peritoneal cancer after response to first-line platinum-based chemotherapy

NICE |  August 2019 | Olaparib for maintenance treatment of BRCA mutation-positive advanced ovarian, fallopian tube or peritoneal cancer after response to first-line platinum-based chemotherapy

Olaparib (Lynparza) is available through the Cancer Drugs Fund. It is a possible treatment for advanced ovarian, fallopian tube or peritoneal cancer in adults, if:

  • they have a BRCA mutation and
  • the cancer has been treated with 1 course of platinum-based chemotherapy.

More evidence on olaparib is being collected, until September 2023. After this, NICE will decide whether or not to recommend it for use on the NHS and update the guidance. It will be available through the Cancer Drugs Fund until then.

Full details from NICE

New lung cancer treatment option approved by NICE

NICE | August 2019| New lung cancer treatment option approved by NICE

NICE has approved another new life-extending treatment for some people with lung cancer is to be made available on the Cancer Drugs Fund (CDF) following its approval by NICE in draft guidance

The immunotherapy drug pembrolizumab (also known as Keytruda) used with chemotherapy drugs carboplatin and paclitaxel will now be an option for adults with squamous non-small-cell lung cancer (NSCLC) which has spread to other parts of the body and who haven’t had any previous treatments.

lungs

Evidence from an ongoing clinical trial suggests that people who have pembrolizumab combination therapy could live longer than those who have standard chemotherapy. It also suggests people could have additional time without their cancer progressing compared with standard chemotherapy.

However, because the clinical evidence is immature, the cost-effectiveness estimates for pembrolizumab combination therapy are very uncertain. The committee recognised that it has the potential to be cost-effective, and therefore recommended it for use on the CDF. This will allow more evidence to be collected to address the uncertainties around overall survival.

Director of the NICE Centre for Health Technology Evaluation Meindert Boysen, said: ““The committee heard from the patient experts that people with squamous non-small-cell lung cancer often have a poor quality of life, and that treatments that have the potential to extend life would be of great importance.” (Source: NICE)

Full press release available from NICE

Read the draft guidance on pembrolizumab here

[NICE Appraisal consultation] Approval for treatment option for early breast cancer after adjuvant trastuzumab [ID981]

NICE | August 2019| Approval for treatment option for early breast cancer after adjuvant trastuzumab [ID981]

Today (7 August 2019) The National Institute for Health and Care Excellence (NICE) has published draft guidance recommending neratinib as an additional treatment for some people with early hormone- receptor-positive human epidermal growth factor receptor 2 (HER2)- positive breast cancer. 

In a press release, NICE recommends Neratinib (also called Nerlynx and marketed by Pierre Fabre), under the terms of a commercial arrangement, for people with this type of breast cancer who are less than 1 year from completing trastuzumab (Herceptin)-based treatment following surgery (called adjuvant treatment).

The clinical trial evidence showed that people who had treatment with neratinib have less risk of disease recurrence than people who had treatment with a placebo. Despite there being no available data about how this might translate into increasing the overall length of time people live, the committee concluded that the cost-effectiveness estimates for neratinib made it an acceptable use of NHS resources.

Meindert Boysen, director of the Centre for Health Technology Evaluation at NICE, said: “Breast cancer remains the most common form of cancer in the UK, accounting for around 30% of all cancers in women. And although there have been advances in the treatment of early stage HER2-positive breast cancer, around a quarter of people treated with trastuzumab following surgery will have a recurrence of their cancer.

“We are therefore pleased to be able to recommend neratinib as a further treatment option for people with this type of breast cancer, based on the benefits it provides in extending the time before the disease gets worse and on its important potential to reduce the risk of the cancer returning.”

Neratinib, which is taken as 6 x 40 mg tablets daily for 1 year, is recommended provided trastuzumab is the only HER2-directed adjuvant treatment people have had (Source: NICE).

The guidance is in development, comments can be made via the  Appraisal consultation

The closing date for comments is Wednesday 28 August 2019

Related:

NICE [press release] NICE recommends additional treatment option for people with early breast cancer   NICE

See also:

OnMedica Approval for treatment option for early breast cancer 

 

 

NICE: Innovative treatment for gynaecological cancers approved for Cancer Drugs Fund

NICE |  July 2019 | Innovative treatment for gynaecological cancers approved for Cancer Drugs Fund

NICE has announced that it has approved Olaparib, a medicine that has previously been used at a later stage in the treatment of advanced ovarian cancer, has now been approved by NICE as a first-line maintenance treatment. 

Currently around 700 women with advanced ovarian cancer are expected to benefit from this new treatment option. As a maintenance therapy, it is used to prevent the cancer returning after primary treatment. It is taken as a tablet twice-a-day

pill-1884775_640

Director of the NICE Centre for Health Technology Evaluation,Meindert Boysen “The availability of olaparib tablets as maintenance therapy is an important development in the management of BRCA mutation-positive advanced ovarian cancer. Olaparib is already used for ovarian cancer but is expected to have the greatest benefit when used early, and is considered to have the potential to cure the disease in some people if given before the first recurrence.

“We are pleased that the company has agreed a commercial arrangement for olaparib that will allow it to be made available immediately to people who currently have an unmet need for maintenance treatment.”

Read the full news story from NICE

Related:

Final appraisal document Olaparib for maintenance treatment of BRCA
mutation-positive advanced ovarian, fallopian tube or peritoneal cancer after response to first-line platinum-based chemotherapy

In the news:

BBC News Ovarian cancer drug olaparib ‘can delay disease in newly diagnosed’

The Independent  ‘Game- changing’ ovarian cancer drug receives NHS approval