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UK lung cancer patients get early access to breakthrough BMS drug

Published on 05/02/16 at 09:59am

UK lung cancer patients are to get access to Bristol Myers-Squibb’s Opdivo (nivolumab) through the Early Access to Medicines Scheme (EAMS).  

Regulator NICE rejected the drug for squamous lung cancer in draft guidance in December after deeming it not to be cost-effective, and is due to make a final decision in May, but in the meantime, Opdivo will be available to treat the non-squamous form of this cancer.      

Through EAMS, Opdivo can now be given to patients as a monotherapy for the treatment of locally advanced or metastatic non-squamous non-small cell lung cancer (NSCLC) following chemotherapy in adult patients whose tumours express programmed death ligand-1 (PD-L1).  The drug is already licensed in Europe for advanced melanoma following chemotherapy.

EAMS was begun in 2014 as a way of speeding patients’ access to therapies that do not yet have regulatory approval, when they are deemed a significant innovation over available medicines, and there is a clear unmet medical need. Under the scheme, the Medicines and Healthcare products Regulatory Agency (MHRA) give a scientific opinion on the benefit/risk balance of the medicine, based on data available at the time.

The decision on Opdivo means the first EAMS access to an immunotherapy medicine for non-squamous cancer patients in the UK. In 2012 there were 35,000 deaths from lung cancer- more than those from breast and bowel cancer combined. Non-squamous NSCLC is thought to account for more than half of these cases, and is categorised into squamous and non-squamous types based on the cells from which it originates.

“Thanks to our Early Access to Medicines Scheme, NHS patients with this devastating form of lung cancer will be amongst the first in Europe to have access to this life‐enhancing medicine,” says Life Sciences Minister, George Freeman MP. “This scheme, launched in 2014, is making a real difference in speeding up access to innovative medicines, but we want to go further, which is why the independent Accelerated Access Review will recommend how we can get new treatments to patients even faster.”

Opdivo belongs to a class of drugs known as immune checkpoint inhibitors, and works by harnessing the ability of the immune system to fight cancer. In a Phase III trial comparing it to docetaxel, Nivolamab extended one-year survival rates by 11%, and median overall survival to 12.2 months compared to 9.4 months. Greatest benefit was seen in patients whose tumours express PD-L1; in this treatment group, median overall survival for nivolumab was 17.7 months vs. 9.0 months for docetaxel.

Welcoming MHRA’s decision to make the treatment available to UK patients, Professor Dean Fennell, chair of Thoracic Medical Oncology, University of Leicester, called nivolumab “one of the biggest advances in this field in almost two decades”, and said BMS’ drug “is changing survival expectations in lung cancer.”

Johanna Mercier, general manager, Bristol-Myers Squibb UK & Ireland, says: “It is great that we are now able to make nivolumab available to some non-squamous lung cancer patients through EAMS but it is also critical that we continue to work with the reimbursement authorities to open up access for patients with squamous lung cancer. NICE will make its final recommendation for squamous patients later this month and we acknowledge that longer-term change to the medicines review process is underway, although the timing of implementation and the measures of success for this are not clear.  In the UK, many patients cannot afford to wait for these reforms.”

Joel Levy

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