MSD's Keytruda recommended on NHS in Scotland for Stage 3 melanoma

MSD has revealed that Keytruda (pembrolizumab) will be made available to NHS Scotland patients after the Scottish Medicines Consortium (SMC) decided to recommend the drug’s use as a monotherapy in the treatment of Stage 3 melanoma with lymph node involvement in adult patients who have undergone complete resection.

Thanks to the decision, access to the drug in this indication is now harmonised across the Great British mainland, following a recommendation from NICE in December 2018 to make the immunotherapy available on the NHS in England and Wales.

In the approved indication, Keytruda was shown at a median follow-up of 15 months to significantly reduce the risk of cancer returning compared to placebo, and in patients with PD-L1-positive tumours.

"Historically, after surgery, patients with stage III melanoma have been placed on routine surveillance, so called ‘watch and wait’ to monitor if their cancer returns. Great advances have been made in the treatment of advanced melanoma however in this setting there remains a proportion of patients who do not benefit," commented Dr Ashita Waterston, Consultant Medical Oncologist, Beatson West of Scotland Cancer Centre. "The incidences of the disease across all stages sadly continue to increase across Scotland. This decision, therefore, offers patients a treatment option in treating melanoma alongside surgery, potentially improving outcomes by reducing risk of their disease recurring."

The most dangerous form of skin cancer, Stage 3 melanoma has spread to the nearby lymph vessels and glands, but the cancer has not metastasised to distant parts of the body. Incidence of this form of the disease has grown in Scotland by 15% over the ten-year period from 2006 to 2016.

John McNeil, Devolved Nations Director at MSD, also remarked: "We are delighted that the SMC has recognised pembrolizumab’s value to Scottish patients with Stage 3 melanoma and have broadened access to this patient population alongside those with advanced melanoma. We continue collaborating with the SMC on the shared aim of securing appropriate access for patients to the benefits of new cancer treatments. Today’s decision signifies the sixth acceptance of pembrolizumab by the SMC, allowing more Scottish patients access to this innovative, and potentially life-extending, treatment across a range of cancers."

Matt Fellows

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