Eli Lilly will be breathing a sigh of relief after the NHS cost regulator gave a preliminary nod for Alimta in lung cancer, having said it was minded not to recommend the drug late last year.

The National Institute for Health and Clinical Excellence has this morning published draft guidance in which it endorses the use of Alimta (pemetrexed) on the NHS as a maintenance treatment for patients with non-small cell lung cancer, making it the first drug to be cleared by the Institute in this setting.

Back in December, the drug’s future in England and Wales was looking very uncertain in this indication after it was turned down because NICE’s Appraisal Committee felt there were “too many uncertainties in the data and analysis” for it to be able to recommend its use. However, Lilly was able to address these concerns by providing additional data at a meeting in February, prompting a change of heart by the Institute.

NICE cleared the use of Alimta as a first-line treatment for NSCLC in September last year, but maintenance therapy – designed to prolong the period of remission after first-line chemotherapy and increase the likelihood of being able to receive second-line chemotherapy - is a new concept in lung cancer care and one not yet routinely practised in the UK.

Regulators approved Alimta as the first maintenance therapy for locally advanced or metastatic NSCLC last year after Phase III data showed that patients given the drug plus best supportive care survived for 15.5 months following treatment, compared with 10.3 months for those on best supportive care alone.

And now, if the latest guidance from NICE is not contested, Alimta looks set to become the first drug to be made available for this type of treatment on the NHS.