New breast cancer drug ‘freezes’ disease progression for two years
PATIENTS with incurable breast cancer will be offered a life-extending new drug shown to “freeze” the spread of the disease for more than two years.
Hundreds of women a year in Scotland with advanced breast cancer will be eligible for the new treatment following a decision by the Scottish Medicines Consortium to make ribociclib routinely available on the NHS.
It brings Scotland into line with the NHS in England where the drug – also known by the brand name Kisqali – was approved for use by NICE in November 2017.
Clinical trials have shown that it typically halts the progression of the disease for just over 25 months, compared to 16 months for a placebo, giving terminally ill women significantly longer with their loved ones.
Angela Harris, head of Breast Cancer Care Scotland, said: “This tremendous decision now brings people living with incurable breast cancer in Scotland on to an even footing with those in England.
“Ribociclib is an exciting milestone in treating this devastating disease, so it’s only right that access has been granted across the UK.
“When combined with other drugs, this innovative treatment can freeze the cancer’s growth for two years, giving vital extra time to hundreds of people in Scotland. And as ribociclib often has fewer side effects, it offers the chance to live normal daily life for longer – from continuing work to making precious memories with friends and family.”
The drug, manufactured by Novartis, will be prescribed in combination with letrozole, a type of hormone therapy used to treat breast cancer in post-menopausal women.
It is taken over 21 days as a daily pill, without chemotherapy, meaning patients can take it in their own home instead of going to hospital.
A complete cycle is estimated to cost £2,954, but it is unclear what the impact will be on the overall NHS Scotland drugs budget as this does not take into account any discount negotiated through the Patient Access Scheme.
It is expected that around 70 patients will undergo the treatment in the first year, rising to 268 patients by year five, although as many as 728 could be eligible in year one.
It can be offered to post-menopausal women with incurable HR+/HER2- breast cancer which is advanced within the breast or has spread to other parts of the body.
The approval follows the results of a major clinical trial, the Monaleesa study, which recruited 668 eligible patients. The half given ribociclib in combination with letrozole, had median progression-free survival of 25.3 months compared to 16 months for the cohort on the placebo plus letrozole. Overall, it reduced the risk of disease-progression or death by 43 per cent.
Professor David Cameron, professor of oncology and director of cancer services at NHS Lothian, said: “Ribociclib in combination with an aromatase inhibitor [letrozole] offers the realistic possibility of two years’ control of a woman’s advanced breast cancer without the need for chemotherapy, as well as the convenience of a daily pill that can be taken in the comfort of their own home.”
The decision on ribociclib was also welcomed by Lawrence Cowan, Scotland Manager for Breast Cancer Now, but he added that breast cancer patients in Scotland were still missing out on other drugs – such as Perjeta – available to women south of the border.
He said: “While this is an important step forward, more needs to be done to make sure that women in Scotland get equal access to life-changing medicines available elsewhere in the UK. Ribociclib has been available on the NHS in England since December and women in Scotland are still missing out on Perjeta.”
It offers the chance to live normal daily life for longer