Patients with certain forms of lung cancer or sarcoma have now gained access to two new treatment options on the NHS in England after Merck’s Keytruda and Eli Lilly’s Lartruvo were added to the Cancer Drugs Fund.
Keytruda (pembrolizumab) can be used to treat advanced lung cancer in people who have specific protein and genetic markers, potentially giving 1,400 extra patients access to the immunotherapy.
The drug was recently recommended by NICE for routine by the NHS as a second line option for some patients with lung cancer; this new guidance allows its use via the CDF for who have not yet received any treatment for the disease while extra data is collected.
In the first-line setting, Keytruda’s use is recommended if tumours express PD-L1 with at least a 50 percent tumour proportion score and have no epidermal growth factor receptor (EGFR) or anaplastic lymphoma kinase (ALK)-positive mutations; the drug is stopped at two years of uninterrupted treatment and no documented disease progression; and the conditions in the managed access agreement are followed.
Lilly’s monoclonal antibody Lartruvo (olaratumab) was recommended for use in combination with doxorubicin as an option for advanced soft tissue sarcoma in adults, but only if: they have not had any previous systemic chemotherapy for advanced disease; they cannot have curative treatment with surgery or their disease does not respond to radiotherapy; and the conditions in the managed access agreement for olaratumab are followed.
Sarcoma is a rare type of cancer affecting tissues surrounding body organs. According to the Institute, around 450 patients will be eligible for the drug through the CDF. The drug was granted conditional marketing authorisation by the European Medicines Agency in November 2016 for use in patients with sarcoma alongside chemotherapy, after Phase II data showed an “unprecedented” median survival gain of 11.8 months.
The companies that market Keytruda and Lartruvo have agreed to make them available under special arrangements with NHS England, which will allow for the further collection of data while the drugs are funded at a discounted price.
“With the changes that were made to the CDF, we are issuing guidance earlier than any other country in Europe. With companies working closely with us and NHS England we will continue to deliver on our promise to give people fast access to the most effective cancer drugs,” commented Professor Carole Longson, director of the NICE centre for health technology evaluation.
Both drugs will remain available through the CDF until they are reviewed again by NICE.