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The National Institute for Health and Care Excellence (NICE) has made pembrolizumab (Keytruda) available for first-line use in lung cancer under the cancer drugs fund (CDF).
Olaratumab (Lartruvo), marketed by Eli Lilly, has also been added to the CDF for sarcoma.
Pembrolizumab is recommended for use for patients with untreated metastatic non-small-cell lung cancer whose tumours express PD-L1. Under the CDF guidance, eligible patients must have at least a 50% tumour proportion score, indicating high PD-L1 expression, and no epidermal growth factor receptor- or anaplastic lymphoma kinase-positive mutations.
The drug was approved for routine second-line use in lung cancer in December 2016, but rejected for first-line use by NICE in March.
Olaratumab is recommended under the CDF for use with doxorubicin in advanced sarcoma for patients who cannot be treated with surgery or radiotherapy. NICE called the extended survival of olaratumab-treated patients “unprecedented” — in trials, patients survived an additional 11.8 months, where the typical life expectancy is 12–16 months — but that the uncertainty over cost-effectiveness prevents them making it routinely available outside the CDF until more data are collected.
Both manufacturers agreed to supply the drugs to the NHS at an undisclosed discount while more data are gathered. NICE say both drugs added to the CDF will be reviewed again as more data become available.
“With the changes that were made to the CDF, we are issuing guidance earlier than any other country in Europe,” says Carole Longson, director of the NICE Centre for Health Technology Evaluation.
“With companies working closely with us and NHS England we will continue to deliver on our promise to give people fast access to the most effective cancer drugs,” she added.
