NICE: Hundreds of people with some forms of urothelial cancer to receive new treatment

NICE | April 2022 | Hundreds of people with some forms of urothelial cancer to receive new treatment

Over 800 people with locally advanced or metastatic urothelial cancer are set to benefit from a new treatment – avelumab – following its recommendation for routine NHS funding in final draft guidance published last week (Thursday 7 April) by NICE.

Full details from NICE

Draft guidance Avelumab for maintenance treatment of locally advanced or metastatic urothelial cancer after platinum-based chemotherapy [ID3735] In development [GID-TA10624] Expected publication date: 11 May 2022

NHS responds to highest number of 999 calls on record

NHS England | November 2021 | NHS responds to highest number of 999 calls on record

Figures show that the NHS 999 services had their busiest month on record in October 2021, as staff answered a record 1 012 143 calls.

Ambulance staff responded to more than 82 000 life threatening call-outs, an increase of more than 20,000 on the previous high for October in 2019 (61 561), as well as dealing with the surge in 999 calls.

Major A&Es treated over 1.4 million people during October – the highest ever for the month and third highest of all time.

The NHS COVID Vaccination Programme delivered more than 7.5 million lifesaving jabs in the same month, including more than 5.9 million top-up jabs.

The health service carried out 1.9 million diagnostic tests and 1.3 million patients started consultant-led treatment during September, that was compared with 1.7 million tests and 1.1 million treatments in the same month last year.

Latest monthly performance data also shows cancer referrals were at a near record high.

Some 231,421 people underwent urgent checks for cancer in September while 27,342 began treatment, up from 201,013 and 24,801 respectively in the same month last year.

The increase in activity came as NHS 111 also saw demand increase to an average of 63,000 calls a day in September, up almost 2,000 a day on the previous month. (Source: NHS England)

NHS England NHS responds to highest number of 999 calls on record

Prevalence and impact of COVID-19 sequelae on treatment and survival of patients with cancer who recovered from SARS-CoV-2 infection

Pinato, D. J. et al | 2021 | Prevalence and impact of COVID-19 sequelae on treatment and survival of patients with cancer who recovered from SARS-CoV-2 infection: evidence from the OnCovid retrospective, multicentre registry study | Lancet Oncology | DOI:https://doi.org/10.1016/S1470-2045(21)00573-8

The authors of this study sought to describe the prevalence of COVID-19 sequelae and their impact on the survival of patients with cancer. In addition, because deferral and modification of systemic anti-cancer therapy has been commonplace during the early phases of the pandemic, they also aimed to describe patterns of resumption and modifications of systemic anti-cancer therapy following recovery from SARS-CoV-2 infection.

Summary

Background

The medium-term and long-term impact of COVID-19 in patients with cancer is not yet known. In this study, we aimed to describe the prevalence of COVID-19 sequelae and their impact on the survival of patients with cancer. We also aimed to describe patterns of resumption and modifications of systemic anti-cancer therapy following recovery from SARS-CoV-2 infection.

Methods

OnCovid is an active European registry study enrolling consecutive patients aged 18 years or older with a history of solid or haematological malignancy and who had a diagnosis of RT-PCR confirmed SARS-CoV-2 infection. For this retrospective study, patients were enrolled from 35 institutions across Belgium, France, Germany, Italy, Spain, and the UK. Patients who were diagnosed with SARS-CoV-2 infection between Feb 27, 2020, and Feb 14, 2021, and entered into the registry at the point of data lock (March 1, 2021), were eligible for analysis. The present analysis was focused on COVID-19 survivors who underwent clinical reassessment at each participating institution. We documented prevalence of COVID-19 sequelae and described factors associated with their development and their association with post-COVID-19 survival, which was defined as the interval from post-COVID-19 reassessment to the patients’ death or last follow-up. We also evaluated resumption of systemic anti-cancer therapy in patients treated within 4 weeks of COVID-19 diagnosis. The OnCovid study is registered in ClinicalTrials.gov, NCT04393974.

Findings

2795 patients diagnosed with SARS-CoV-2 infection between Feb 27, 2020, and Feb 14, 2021, were entered into the study by the time of the data lock on March 1, 2021. After the exclusion of ineligible patients, the final study population consisted of 2634 patients. 1557 COVID-19 survivors underwent a formal clinical reassessment after a median of 22·1 months (IQR 8·4–57·8) from cancer diagnosis and 44 days (28–329) from COVID-19 diagnosis. 234 (15·0 per cent) patients reported COVID-19 sequelae, including respiratory symptoms (116 [49·6 per cent]) and residual fatigue (96 [41·0 per cent]). Sequelae were more common in men (vs women; p equal to 0·041), patients aged 65 years or older (vs other age groups; p=0·048), patients with two or more comorbidities (vs one or none; p equal to 0·0006), and patients with a history of smoking (vs no smoking history; p equal to 0·0004). Sequelae were associated with hospitalisation for COVID-19 (p less than 0·0001), complicated COVID-19 (p less than 0·0001), and COVID-19 therapy (p equal to 0·0002). With a median post-COVID-19 follow-up of 128 days (95 per cent CI 113–148), COVID-19 sequelae were associated with an increased risk of death (hazard ratio [HR] 1·80 [95 per cent CI 1·18–2·75]) after adjusting for time to post-COVID-19 reassessment, sex, age, comorbidity burden, tumour characteristics, anticancer therapy, and COVID-19 severity. Among 466 patients on systemic anti-cancer therapy, 70 (15·0 per cent) permanently discontinued therapy, and 178 (38·2 per cent) resumed treatment with a dose or regimen adjustment. Permanent treatment discontinuations were independently associated with an increased risk of death (HR 3·53 [95 per cent CI 1·45–8·59]), but dose or regimen adjustments were not (0·84 [0·35–2·02]).

Interpretation

Sequelae post-COVID-19 affect up to 15% of patients with cancer and adversely affect survival and oncological outcomes after recovery. Adjustments to systemic anti-cancer therapy can be safely pursued in treatment-eligible patients.

Funding

National Institute for Health Research Imperial Biomedical Research Centre and the Cancer Treatment and Research Trust.

Prevalence and impact of COVID-19 sequelae on treatment and survival of patients with cancer who recovered from SARS-CoV-2 infection: evidence from the OnCovid retrospective, multicentre registry study [paper]

NICE: Patients with rare bile duct cancer set to benefit from life extending treatment

NICE | 25 August 2021 | Patients with rare bile duct cancer set to benefit from life extending treatment

Some patients who have a rare form of bile duct cancer are set to benefit from life-extending treatment pemigatinib after NICE announced the final draft guidance would be published last month.

Pemigatinib is an option for adults whose cancer has progressed after chemotherapy and around 50 people will be eligible for treatment with it. Evidence suggests that pemigatinib works better than current treatments at this stage of cancer.

Pemigatinib was not recommended at the appraisal consultation draft stage, but the company has provided further information to address the uncertainties highlighted by the committee. This has enabled the committee to conclude pemigatinib is most likely within the range that NICE considers a cost-effective use of NHS resources for a life-extending treatment at end of life (Source: NICE).

Further details are available from NICE

Final draft guidance is available from NICE

NICE draft guidance recommends abemaciclib for advanced breast cancer

NICE |  August 2021 | NICE draft guidance recommends abemaciclib for advanced breast cancer

NICE has recently published draft guidance which recommends twice-daily pill abemaciclib (also called Verzenios and made by Eli Lilly) as an option for adults with a type of breast cancer called hormone receptor-positive, HER2-negative breast cancer which has spread to other parts of the body.

Draft guidance Abemaciclib with fulvestrant for treating hormone receptor-positive, HER2-negative advanced breast cancer after endocrine therapy [ID2727]

Full details from NICE [press release]

Cancer Patient Survey 2021: Patients less likely to rate cancer care as ‘very good’ during pandemic #Covid19RftLks

Cancer Research UK | July 2021 | Cancer Research UK Cancer Patient Survey 2021 CRUK’s second survey studying the impact of COVID-19 on cancer patients in the UK

This report shares the findings of CRUK’s second survey of 900 cancer patients conducted December 21st 2020 –
March 25th 2021. The survey aimed to build a more complete understanding of how cancer patients’ perspectives of how their testing, treatment and care had been impacted by the pandemic since it began as well as impact on wellbeing and what they wanted the government to be doing. The survey also included new questions on clinical trials, COVID-19
safety measures, remote consultations and community-based treatment.

Key findings

• Almost a third (29 per cent) cancer patients reported that their treatment had been impacted since the start of the pandemic.
• Around 4 in 5 (80 per cent) reported that their care had been impacted in at least one way. The most common ways they were affected was going to treatment alone, having check-ups at hospital cancelled or postponed, and receiving less support both from support groups and clinical nurse specialists.
• The proportion of cancer patients who rated their overall cancer care as ‘very good’ reduced from 84 per cent for before the pandemic started (retrospective rating) to 60 per cent since the pandemic started, 33 per cent downgraded their rating since the pandemic started.
• The majority of cancer patients reported positive experiences of COVID-19 safety measures, particularly safe spaces (89 per cent), wearing masks (80 per cent) and home and community-based treatment (75 per cent).
• The most reported concern generally was of becoming seriously ill from COVID-19 (50 per cent) and catching COVID-19 (49 per cent).
• Patients reported feeling more “frustrated” (67 per cent) and more “anxious” (62 per cent) compared to before pandemic (Source: Cancer Research UK)

Cancer Research UK Cancer Patient Survey 2021 CRUK’s second survey studying the impact of COVID-19 on cancer patients in the UK [report]

Related:

Cancer Research UK Patients less likely to rate cancer care as ‘very good’ during pandemic

[NICE Draft guidance] Nivolumab with ipilimumab for previously treated metastatic colorectal cancer with high microsatellite instability or mismatch repair deficiency [ID1332]

NICE | Nivolumab with ipilimumab for previously treated metastatic colorectal cancer with high microsatellite instability or mismatch repair deficiency [ID1332] | Expected publication date: 21 July 2021

NICE has today (14 June 2021)published final draft guidance recommending nivolumab plus ipilimumab for people with metastatic colorectal cancer with high microsatellite instability or mismatch repair deficiency

Draft guidance available from NICE

NHS England: NHS to offer new drug that halves the risk of cancer returning

NHS England| 7 May 2021 | NHS to offer new drug that halves the risk of cancer returning

NHS England has announced the roll out of an innovative world-leading treatment that halves the risk of lung cancer patients suffering a return of the disease after undergoing treatment.

In a trial of the drug – the first of its kind – around nine out of ten patients treated, remained alive and disease-free after two years – compared to more than four in ten who hadn’t received the new therapy.

Around 100 patients in England with a rare form of cancer will initially have access to the drug, called Osimertinib, with many more expected to benefit this year.

Lung cancer is the most common cause of cancer death in the UK, accounting for one in five of all cancer deaths. Osimertinib is the first treatment for patients with non-small cell lung cancer whose tumours have a specific type of genetic mutation, to be licensed for use in patients who have just had surgery (Source: NHS England).

Full details are available from NHS England

NHS England: Thousands of patients set to benefit from five-minute breast cancer treatment

NHS England | 4 April 2021 | Thousands of patients set to benefit from five-minute breast cancer treatment

A new treatment will benefit over 3 600 patients with breast cancer reducing the amount of time needed to be spent in hospital for patients with HER-2 positive breast cancer. PHESGO will be offered to patients with breast cancer undergoing chemotherapy, it is injected and will take five minutes to prepare and administer, compared with two infusions that can take up to two and a half hours.

The injection will be offered to eligible people with HER2-positive breast cancer, which accounts for 15% of all breast cancers, and can be given alongside chemotherapy or on its own.

The five-minute jab significantly cuts the Covid infection risk for cancer patients by reducing the amount of time spent in hospital and frees up time for clinicians in chemotherapy units.

Paula Lamb, 51, who is a housewife from Newton-le-Willows, is one of the first patients to receive the treatment. She was diagnosed with breast cancer in 2014 and then developed secondary lung and liver cancers and is receiving treatment at the Clatterbridge Cancer Centre.

She said:  “I’m currently on a combination of medications which take about an hour and a half to two hours to administer all together, and I have to go in to hospital to have them every three weeks.

“It feels absolutely amazing to be one of the first people to receive this treatment through the NHS and it really could not have come at a better time as lockdown lifts and I can stop shielding. Having a five minute treatment means I’ll have more time to get out on walks, for my gardening, knitting and to help my daughter practise her cricket skills. It’s a real life-changer.” (Source: NHS England)

Full story from NHS England Thousands of patients set to benefit from five-minute breast cancer treatment

In the news:

The Guardian NHS England rolls out five-minute treatment for some breast cancers

BBC News Breast cancer: New five-minute Phesgo treatment ‘great’

NICE: Thousands of lung cancer patients to benefit from life-extending treatment #worldcancerday

NICE | 4 February 2021 |Thousands of lung cancer patients to benefit from life-extending treatment

NICE has today ( 4 February 2021) published draft guidance that means a potentially life-extending treatment for individuals with non-squamous, non- small lung cancer (NSLC) will now be available on the NHS following its approval.

The draft guidance means pembrolizumab (Keytruda, Merck Sharp & Dohme) with pemetrexed and platinum chemotherapy will be available as a first-line treatment option for adults whose tumours have no epidermal growth factor receptor (EGFR)-positive or anaplastic lymphoma kinase (ALK)-positive mutations.

The combination treatment was previously available to people through the Cancer Drugs Fund and has now been approved for routine commissioning on the NHS. Around 3,000 people will be eligible for this treatment in England.

NICE expects to publish final guidance on the recommendation in March 2021. The draft guidance can be read at NICE .

Full details from NICE