UK ‘out of step’ as cancer drug rejected

THE INSTITUTE of Cancer Research (ICR) has said the UK is “out of step with clinical practice in the rest of the world” after a key immunotherapy for head and neck cancer was rejected for use by a health regulator.

The National Institute for Health and Care Excellence (Nice) turned down Keytruda (pembrolizumab) as a first-line treatment for advanced head and neck cancer. It said clinical data did not reflect current practice in the

NHS and has asked the manufacturer, Merck Sharp & Dohme, for more information. But the move sparked a furious response from the ICR in London, which called for an urgent reassessment of the evidence of the drug’s benefit.

The ICR and the Royal Marsden NHS Foundation Trust led the UK arm of a global clinical trial, KEYNOTE-048, showing that pembrolizumab used with chemotherapy or on its own extended survival compared with the “extreme” chemotherapy regime used at the moment.

The US Food and Drug Administration (FDA) and the European Medicines Agency have already approved the drug.

In the UK, clinical practice differs from the rest of the world, in that the choice of first-line treatment varies depending on whether a person’s cancer started inside or outside the mouth.

Kevin Harrington, professor of biological cancer therapies at the

ICR and consultant clinical oncologist at the Royal Marsden, who led the UK part of the trial, said: “I’m deeply disappointed that pembrolizumab has not been recommended for use on the NHS, and that patients will have to wait even longer before they can access this immunotherapy as the first treatment of choice for advanced head and neck cancer.”

He said it “brings the UK further out of step with clinical practice in the rest of the world”.