WIREDGOV

Up to 1,600 women a year affected by high risk triple-negative breast cancer are set to benefit from the confidential deal struck by the NHS and the manufacturer.

Pembrolizumab (brand name, Keytruda®), used in combination with chemotherapy, reduces the chances of breast cancer progressing by almost two fifths.

The drug works by stimulating the body’s immune system to fight the cancer cells – it targets and blocks a specific protein on the surface of certain immune cells which then seek out and destroy the cancerous cells.

Delivered directly into the bloodstream every three to six weeks for around one year, the treatment will be funded immediately by the NHS to give access to eligible patients.

Triple-negative breast cancer affects around 8,000 women a year – accounting for 15% of all breast cancer cases.

It is challenging to treat with a shorter survival time than most other breast cancers and disproportionately affects women under 40 and those from black backgrounds.

This will be the 25th breast cancer treatment fast-tracked to patients through funding from the Cancer Drugs Fund and the second treatment for triple negative breast cancer to be introduced this year on the NHS.

NHS chief executive, Amanda Pritchard, said:

“This is a hugely significant moment for women – the NHS has struck a new deal to roll out a potentially life-saving drug for patients suffering with the most aggressive form of breast cancer that has been traditionally very difficult to treat.

“It is fantastic news for around 1,600 women across the country each year who have either been diagnosed with triple-negative breast cancer or will be in the coming years – it will give hope to those who are diagnosed, and prevent the cancer from progressing allowing people to live normal, healthy, lives.

“This is just the latest commercial drug deal that the NHS has struck for patients – once again highlighting the innovative treatments available at a price that represents good value for money for taxpayers.”

The National Institute for Health and Care Excellence (NICE) has published final draft guidance recommending the use of pembrolizumab in combination with chemotherapy on the NHS, following the commercial deal being struck.

NHS nurse, Lauren Sirey, 36 from Surrey, was on a trial at Barts Health in 2017. Lauren has recently completed a 10k run for a breast cancer charity and is getting ready set to celebrate five years of being cancer free with a trip to Las Vegas.

Lauren said:

“Four months before my partner and I were due to marry, I was diagnosed with triple negative breast cancer aged 31. I was offered the opportunity to participate in a clinical trial and am delighted to hear that this treatment has now been approved for use in the NHS.

“This treatment allowed me to make a full recovery and I’m now approaching my five year all clear, which we plan to celebrate in Las Vegas. Following my recovery, I developed a passion for running and recently ran a 10k race for a TNBC charity. I would encourage anyone with symptoms to visit their GP as early detection and treatment is so important.”

NHS director of specialised commissioning, John Stewart, said:

“The NHS is committed to delivering the best for its patients and this latest deal for a cutting-edge breast cancer treatment showcases the power of the NHS to agree deals for the latest medicines and treatments at affordable prices for taxpayers.

“Pembrolizumab is the second drug the NHS has secured for women with triple-negative breast cancer this year, and just the latest in a series of commercial drug deals struck by the NHS to ensure patients have access to the best possible treatments.”

Minister for Health, Helen Whately, said:

“We are committed to delivering world-class cancer care, and constantly working to find innovative, life-saving treatments.

“This treatment will give new hope to thousands of breast cancer patients at the highest risk, and has been made possible by the government’s  £340 million Cancer Drugs Fund, which has already fast tracked almost 100 cancer treatments and benefitted over 80,000 patients since 2016.”

The drug, manufactured by MSD, has already benefitted women who have been given it either on a compassionate basis or as part of clinical trials.

Up to 1,600 women will be eligible for the treatment each year because they are at highest risk and are already receiving a tough regimen of chemotherapy.

Clinicians will make the final decision depending on individual factors, such as whether the patient has high risk disease and if the patient is fit enough to undergo the treatment.

Used initially in combination with two types of chemotherapy each given on a sequential three-month basis before surgery for the breast cancer and then used alone after surgery, the treatment is proven to increase the chance of both remaining free of an adverse breast cancer event and also there being no active cancer found in the resected breast tissue and axillary lymph nodes.

This is the second new drug for triple-negative breast cancer to be made available on the NHS this year after sacituzumab govitecan (brand name Trodelvy®) was recommended by NICE in July.

The NHS has agreed deals for a number of breakthrough drugs this year, including the lifesaving gene therapy, Libmeldy® for children with the rare condition metachromatic leukodystrophy, and a first new treatment in nearly 15 years for respiratory cancer, mesothelioma.

Baroness Delyth Morgan, Chief Executive at Breast Cancer Now, said:

“It’s fantastic news that immunotherapy pembrolizumab has been recommended for routine use on the NHS as a treatment option for an estimated 1,600 eligible patients with primary triple negative breast cancer.

“This less common but often more aggressive type of breast cancer is more common in women with an inherited BRCA gene, women aged under 40 and black women, and the risk of triple negative breast cancer returning and spreading to other parts of the body in the first few years after treatment is higher than for other types of breast cancer. Yet, for far too long, patients with this type of breast cancer have faced the frightening reality of limited treatment options.

“This new treatment can potentially lead to any detectable cancer disappearing by the time of surgery, meaning patients will then possibly face less invasive, breast-conserving surgery. Furthermore, by significantly reducing the likelihood of breast cancer recurring or spreading to other parts of the body where it becomes incurable secondary breast cancer, this treatment brings precious hope of more lives potentially being saved from this devastating disease.”

David Long, Head of Oncology at MSD UK, said:

“Collaboration between MSD and NHS England has resulted in a positive NICE recommendation which will benefit some people with early stage TNBC. Previously, there was no immunotherapy treatment option available for people with early stage or locally advanced TNBC, creating an unmet need for these patients. I am delighted that many patients in England can now benefit from the first immunotherapy for this type of cancer, which will hopefully enable a more positive treatment outcome.”