Pancreatic cancer patients in England get CDF access to Abraxane

The National Institute for Health and Care Excellence has deemed the drug a cost-effective use of NHS resources, but has cleared its immediate availability through the Cancer Drugs Fund for the interim period until final guidance is issued, which is expected some time in November.

The decision means that Abraxane (nab-Paclitaxel) in combination with gemcitabine is an option for adult patients with metastatic pancreatic ductal adenocarcinoma via the NHS when other combination chemotherapies are unsuitable and they would otherwise have gemcitabine monotherapy.

Dr Stephen Falk, consultant clinical oncologist at University Hospitals Bristol NHS Trust and chair of the NCRI Pancreatic Cancer Subgroup, said NICE’s recommendation will be welcomed by the clinical community and families affected by pancreatic cancer.

"This is a disease that has seen few therapeutic advances in recent years and life expectancy remains extremely poor. It is very reassuring that NICE has decided to recommend nab-Paclitaxel in combination with gemcitabine for the treatment of metastatic pancreatic cancer, and I also welcome the potential of extra survival this regimen may offer to the right patient compared to gemcitabine alone."

Survival rates have shown minimal improvement over the past 40 years and the disease has one of the worst five-year survival rates of common cancers in England and Wales; in the 1970s, 1 percent of people diagnosed with pancreatic cancer survived their disease beyond ten years, today it is still around 1 percent, Celgene noted, underscoring the need for new treatment options.

Data from the Phase III MPACT trial showed an increase in median overall survival of 1.8 months Abraxane in in combination with gemcitabine when compared to gemcitabine alone in first-line treatment of mPDAC (8.5 months vs. 6.7 months, respectively).

Access to the drug in the UK thus far has been patchy. The All Wales Medicines Strategy Group first issued advice in 2014 in the absence of NICE guidance recommending the regimen as an option for use within NHS Wales in the first-line treatment of adult patients with metastatic adenocarcinoma of the pancreas, while in Scotland it has been available since February 2015, highlighting the inequality in access for patients.

NICE originally ruled back in November 2015 that Abraxane would not be funded for routine NHS use, which, under normal circumstances, would have over-ridden the AWMSG’s 2014 advice. However, in a rare move, NICE’s position on Abraxane was over-ruled by the Welsh government to secure to continued access for patients in the country. Now, with the new NICE nod all eligible pancreatic patients in the UK should have the option of being treated with the therapy.