NICE recommends MSD’s Keytruda for oesophageal cancer patients
pharmafile | September 17, 2021 | News story | Medical Communications, Research and Development |
NICE has approved the use of pembrolizumab – MSD’s checkpoint inhibitor immunotherapy – in combination with platinum- and fluoropyrimidine-based chemotherapy, as an option for certain oesophageal cancer patients.
Patients eligible for the combination therapy include those with untreated locally advanced unresectable (inoperable) or metastatic carcinoma of the oesophagus or HER-2 negative gastro-oesophageal junction adenocarcinoma whose tumours express PD-L1 with a combined positive score (CPS) of 10 or more.
The approval is based on data from Phase III trials where the pembrolizumab-chemotherapy combination was shown to extend the lives of certain patients newly diagnosed with late stage oesophageal cancer, reducing the risk of growth and spread of patients’ tumours compared with standard of care chemotherapy, with a manageable safety profile.
Professor Was Mansoor, Consultant Medical Oncologist at The Christie NHS Foundation Trust, said: “Advanced oesophageal cancer can be very aggressive, with limited treatment options which offer only modest benefits for patients. Improvements in treatments for these patients has been in urgent need for the last half century. This approval from NICE is a major step forward in addressing these needs – offering a new type of treatment in immunotherapy for this group of patients for the first time on the NHS.
“The KEYNOTE-590 clinical trial, which we at The Christie were a part of, showed that adding pembrolizumab to chemotherapy stopped the tumours from growing for longer than chemotherapy alone, and more than doubled the number of patients alive two years after beginning treatment. This represents a paradigm-shift in the treatment of oesophageal cancer and will likely change clinical practice for oncologists.”
There are approximately 8,000 new cases of oesophageal cancer diagnosed in England and Wales every year. Of these new cases, approximately 40% of patients are diagnosed as metastatic. In a statement MSD said that within the KEYNOTE-590 trial, the proportion of patients with a PD-L1 CPS of 10 or above was around 50%. This means that around 1,600 patients across England and Wales could potentially benefit from the pembrolizumab-chemotherapy combination each year, plus any additional eligible patients who are diagnosed with locally advanced disease for whom surgery isn’t an option to remove their cancer.
Oesophageal cancer is one of the six “less survivable cancers” where only 21% of patients will typically live beyond a year after being diagnosed with stage 4 disease.
Kat Jenkins
