The immunotherapy nivolumab has today been made available on the Cancer Drugs Fund (CDF) for patients with head and neck cancer if the disease progresses within six months of receiving platinum chemotherapy.
Professor Kevin Harrington, who is Professor of Biological Cancer Therapies at The Institute of Cancer Research, London, and Consultant Clinical Oncologist at The Royal Marsden NHS Foundation Trust, led the UK arm of the phase III clinical trial of nivolumab in patients with advanced head and neck cancer.
The results, published in the New England Journal of Medicine last year, found that nivolumab significantly improved survival in this group of patients.
And new results suggest nivolumab almost triples survival rates at 18 months, with 22% of patients still alive taking nivolumab compared with only 8.3% who received chemotherapy.
Research led by Professor Harrington, published in The Lancet Oncology, also found that nivolumab was far kinder for patients than traditional chemotherapies, helping them maintain a better quality of life for longer.
The drug was initially rejected in April, when it wasn’t considered to be sufficiently cost effective.
Nivolumab will be available for two years on the CDF while doctors collect more evidence about the benefit of the therapy, and if they can pick out which patients are most likely to respond by testing a patient’s tumour for a molecule called PD-L1.
Flexibility from NICE
Professor Kevin Harrington, Professor of Biological Cancer Therapies at the ICR, and Consultant Clinical Oncologist at The Royal Marsden NHS Foundation Trust, said:
“I am delighted that doctors will now be able to offer nivolumab to patients with advanced head and neck cancer. The disease is extremely debilitating, with no effective treatment options where chemotherapy has failed. Patients who take nivolumab not only get extra time with their loved ones but feel much better during treatment.
“I’m pleased that NICE have shown flexibility in allowing access to nivolumab through the Cancer Drugs Fund for two years while more data is collected – including on whether we can predict in advance who will benefit from treatment.
“Immunotherapy is extremely expensive and it is essential that future trials are designed to assess the effectiveness of biomarkers to target treatment, so we only use it in patents who are likely to respond.”
Read our nivolumab news story from October 2016: ‘Game-changing’ immunotherapy doubles head and neck cancer survival.
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Making immunotherapy more cost-effective
Professor Paul Workman, Chief Executive of the ICR, said:
“It is great news that patients with head and neck cancer who progress on chemotherapy will be able to receive nivolumab on the NHS for at least the next two years.
“It gives researchers time to work out if they can select patients most likely to respond by testing for the PD-L1 biomarker. Being able to pick out patients in this way will help make immunotherapy more cost-effective, and stop patients from being treated with drugs that are unlikely to work.
“Although I’m very pleased with the decision today, it’s frustrating that it has once again come after a six-month delay following the drug’s initial rejection. We seem to have slipped into a kind of game where exciting new treatments are routinely priced too high initially, and NICE is forced to turn them down on first assessment.
“The losers in this game are patients, and for some people with head and neck cancer today’s decision will have come too late.”