pharmatimesApril 02, 2019
According to draft final guidance, the PD-L1 inhibitor will be made available on the NHS in England immediately, which is good news for patients with locally advanced unresectable non-small-cell lung cancer, who have already had platinum-based chemoradiation, as they will be likely to receive the immunotherapy treatment in its first year.
The drug works by helping the body’s immune system to find and attack cancer cells, blocking the PD-L1 protein which disguises cancer.
In clinical trials progression-free survival was found to be around two years with the treatment, versus six months for those without. Furthermore, the committee agreed that it was plausible that between 27% and 40% of people taking Imfinzi would have five years of progression-free survival.
Dr Fiona McDonald, a consultant clinical oncologist at The Royal Marsden NHS Foundation Trust, who advised the committee on this topic, said: "This decision marks the biggest advance we’ve seen for a number of years in treating locally advanced non-small cell lung cancer. For our patients it’s fantastic news; I expect to see an immediate impact on clinical practice, and for this treatment to become the standard of care for eligible patients.
"The trial on which the decision is made showed a step-change increase in survival rates and demonstrates a clear benefit of immunotherapy, given after the current standard of care, concurrent chemoradiation."
A single 500mg vial has a list price of £2,466, but under its commercial agreement AstraZeneca will provide it to the NHS at a confidential discounted price.
The news comes at the same time as NICE publishes a final update of its clinical guideline on the diagnosis and management of lung cancer. Changes made since the guideline was last updated in 2011 include clearer recommendations on when brain imaging should be offered to spot if the cancer has spread, and on treatment options for people whose disease has spread to the lymph nodes.
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