Ap­proved, drug that works twice as well as chemo

Hope for 1,500 lung cancer pa­tients

Daily Mail - - Election 2017 - By Ben Spencer Med­i­cal Cor­re­spon­dent

A REVOLUTIONARY lung cancer drug – shown to be twice as ef­fec­tive as chemo­ther­apy – is to be made avail­able for NHS pa­tients as soon as they are di­ag­nosed.

Drugs ra­tioning chiefs last night ap­proved pem­brolizumab as the first treat­ment given to pa­tients told they have in­cur­able lung cancer.

The medicine, which tri­als have shown also has far fewer side ef­fects than chemo­ther­apy, is ex­pected to ben­e­fit 1,500 pa­tients a year in Eng­land.

Late Sunday Times critic AA Gill, who died at 62 from the dis­ease in De­cem­ber, wrote in his fi­nal col­umn that he may have lived longer if he had been given a sim­i­lar ‘im­munother­apy’ drug called nivolumab.

He called the treat­ment the weapon of choice for ‘ ev­ery on­col­o­gist in the first world’.

A study pub­lished six months ago showed 60 per cent of pa­tients who take pem­brolizumab as a ‘first-line’ treat­ment sur­vive for at least two years – and many for far longer.

It ap­pears to stop the tu­mours grow­ing for at least 10 months on av­er­age – twice as long as chemo­ther­apy. Pem­brolizumab is one of the first of a new wave of ‘im­munother­apy’ treat­ments, which har­nesses the body’s own im­mune sys­tem and teaches it to at­tack tu­mours. These treat­ments have rev­o­lu­tionised cancer medicine over the last three years, with ex­perts de­scrib­ing the re­sults as ‘jaw-drop­ping’.

But un­til now most treat­ments have been re­served for pa­tients at the end of their life,

‘They’re healed by own body’

af­ter all oth­ers have failed.

The new de­ci­sion, by drugs ra­tioning watch­dog Nice, means pem­brolizumab can now be used for NHS pa­tients with in­cur­able non- small- cell lung cancer as a first-line treat­ment, mean­ing they do not have to un­dergo gru­elling chemother- apy first. Pa­tients with early lung cancer, whose tu­mours have yet to spread, will be ad­vised to have surgery or ra­dio­ther­apy first.

But 80 per cent of lung cancer pa­tients are not di­ag­nosed un­til the cancer has spread.

For a quar­ter of them – those test­ing pos­i­tive for a biomarker show­ing they are likely to re­spond to pem­brolizumab – the drug could be a top op­tion.

Pro­fes­sor Gary Mid­dle­ton, an on­col­o­gist at the Univer­sity of Birm­ing­ham, said: ‘This is fan­tas­tic news. For the quar­ter of pa­tients who are suit­able for first-line pem­brolizumab, it sig­nif­i­cantly im­proves sur­vival with­out sig­nif­i­cantly im­pact­ing the qual­ity of life of pa­tients.’ Dr Riyaz Shah, a cancer con- sul­tant at Kent On­col­ogy Cen­tre, Maid­stone, ex­plained: ‘All the anti-cancer ac­tiv­ity is driven by the pa­tient’s own im­mune sys­tem. Pa­tients love it – they feel they are be­ing healed by their own body.’

Im­munother­apy treat­ments are hugely ex­pen­sive – pem­brolizumab costs £91,200 per year per pa­tient.

But un­der the ap­proval terms, US drug firm Merck, Sharp and Dohme agreed to give the NHS a se­cret dis­count. Cru­cially, pa­tients only need to take the drug for two years.

Nice is also due to an­nounce a de­ci­sion this sum­mer about the im­munother­apy lung cancer drug nivolumab, re­ferred to by Mr Gill – which so far has not been ap­proved for NHS use.

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