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Scotland approves first-line NHS use of MSD's Keytruda combo for advanced non-small cell lung cancer

Published on 07/10/19 at 10:47am

The Scottish Medicines Consortium (SMC) has announced its decision to accept MSD’s blockbuster immunotherapy Keytruda (pembrolizumab) in combination with pemetrexed and platinum chemotherapy on the NHS in Scotland for the first-line treatment of metastatic non-small cell lung cancer (NSCLC) patients.

The decision affects patients whose tumours express PD-L1 with a <50% tumour proportion score (TPS), or in when it has not been possible to evaluate PD-L1 TPS, but excludes patients whose tumours have the specific gene mutations EGFR or ALK. It was based on additionally supplied evidence which indicated that the Keytruda combo improved overall survival by 44% after a median follow-up of 18.7 months compared to chemo alone.

It also improved median overall survival by 22 months compared to 10.7 months compared to chemo, regardless of PD-L1 TPS. In patients with a PD-L1 TPS of 1-49% and <1%, the combo improved overall survival by 38%.

“We are pleased that after a review of additional evidence the SMC has recognised the value of pembrolizumab in combination with chemotherapy as a treatment option for certain patients with non-squamous NSCLC in Scotland,” explained John McNeill, Devolved Nations Director at MSD. “MSD has worked collaboratively with the SMC and NHS Scotland to secure access for another subset of patients with advanced lung cancer to a treatment option which has the potential to increase survival. This new acceptance broadens access to include all eligible patients with NSCLC, bringing immunotherapy treatment to many more people in need.”

Paula Chadwick, CEO at the Roy Castle Lung Cancer Foundation, also remarked: “We are delighted by the SMC's decision. It means that now more patients with NSCLC can access this beneficial treatment option, which offers another way to live well with lung cancer for longer. We see this as a huge step forward. Scotland has had one of the highest rates of lung cancer in the world and approximately nine out of 10 patients with lung cancer have NSCLC. New treatment options like this are having a huge impact on people’s lives. They are keeping families together for longer and we will continue to campaign for more access to these life-lengthening treatments."

Matt Fellows

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