Nivolumab, a life-extending immunotherapy drug used for lung cancers, approved for NHS use

Posted: 21st Sep 17 2:29 PM

Nivolumab, a life-extending immunotherapy drug, will be made immediately available to NHS patients across England suffering from certain lung cancers, which may include some mesothelioma sufferers.

There have been repeated calls by campaigners for access to the immunotherapy drug, which can add months to life expectancy.

The drug was previously available in Scotland to people with cancers who have tried chemotherapy and were healthy enough afterwards to receive immunotherapy as an alternative to additional chemotherapy or radiotherapy.

The drugs watchdog in England had originally said that nivolumab was too expensive for use by the NHS, believed to cost around £5,000 a cycle per patient.

Could nivolumab extended life of mesothelioma patients?

In new guidance, the National Institute for Health and Care Excellence (NICE) has approved nivolumab through the fast-track Cancer Drugs Fund while more evidence is gathered on its cost-effectiveness.

This means that about 1,300 people with lung cancer will now be eligible to be given the drug.

Research has shown that nivolumab increases the number of patients still alive after three years of treatment by 2-3 times.

Professor Carole Longson, from NICE said: “We know that nivolumab is clinically effective for some people with lung cancer, but the full extent of its benefits is not clear.

“This new deal means that we can give patients access to what we know is a promising treatment whilst more evidence is gathered on its value.”

Professor Paul Workman, from the Institute of Cancer Research, in London, said: “Immunotherapies are currently very expensive, but one of the ways to make them more cost-effective is to direct them to patients most likely to respond. This decision is a welcome step in the right direction.”

What is nivolumab and will it help sufferers of mesothelioma?

Nivolumab is a type of immunotherapy drug that stimulates the body’s immune system to recognise and fight cancer cells. This works by interrupting chemical signals that cancer cells use to convince the immune system that they are healthy tissue.

The administration of immunotherapies follows the standard delivery of chemotherapy – 1 treatment every 3 weeks. Unlike chemotherapy however, this treatment will be continuous if successful, rather than 4-6 treatments over a set period of time.

Before this announcement, nivolumab was only available to patients in Scotland who had already undergone a course of chemotherapy and were deemed healthy enough to proceed with a course of the nivolumab immunotherapy.

On top of this, immunotherapy is only believed to benefit those whose tumours express a molecule called PD-L1.

Mesothelioma, an asbestos-related cancer found predominantly on the lining of the lungs, does not always express the molecule PD-L1. This means that not every patient diagnosed with mesothelioma will have access to immunotherapy treatments. However, results from previous research does show that nivolumab could help some people with mesothelioma after chemotherapy.

It is not clear at this moment in time if patients will have to undergo a course of chemotherapy before being given nivolumab, but if the NHS is to follow Scotland’s suite, it is likely that they will.

Asbestos-related conditions, such as mesothelioma, take anywhere between 10 and 50 years to develop after exposure to asbestos, so are usually diagnosed in elderly patients. Combined with the fact that mesothelioma is a very aggressive cancer, there is the question whether such elderly patients would be deemed healthy enough for nivolumab after an aggressive course of chemotherapy.

Further reading

What is mesothelioma?

Mesothelioma clinical trial supported by Cancer Research UK

More than 1.6 million people could be living with an undiagnosed lung cancer in the UK